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Sample records for gas-forming brain abscess

  1. Brain abscess

    MedlinePlus

    Tunkel AR. Brain abscess. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice ... Philadelphia, PA: Elsevier Saunders; 2015:chap 92. Tunkel AR, Scheld WM. Brain abscess. In: Winn HR, ed. ...

  2. Undiagnosed amebic brain abscess.

    PubMed

    Viriyavejakul, Parnpen; Riganti, Mario

    2009-11-01

    We report a case of amebic brain abscess due to Entamoeba histolytica. The patient was a 31-year-old man who presented with amebic liver abscess. His clinical course deteriorated in spite of proper drainage and treatment. He developed delirium, lethargy and then expired. With a history of heroin addiction, withdrawal syndrome from heroin was suspected. At autopsy, amebic abscesses were detected in the liver, large intestine, meninges and brain. A 19 cm amebic liver abscess was found in the right lobe of the liver. A 4 cm amebic brain abscess was found in the right occipital lobe. Microscopically, the tissue sections from the affected organs were confirmed to have degenerated E. histolytica trophozoites. Involvement of the brain in amebic liver abscess should be suspected in patients with neurological signs and symptoms. PMID:20578451

  3. Bacterial Brain Abscess

    PubMed Central

    Patel, Kevin

    2014-01-01

    Significant advances in the diagnosis and management of bacterial brain abscess over the past several decades have improved the expected outcome of a disease once regarded as invariably fatal. Despite this, intraparenchymal abscess continues to present a serious and potentially life-threatening condition. Brain abscess may result from traumatic brain injury, prior neurosurgical procedure, contiguous spread from a local source, or hematogenous spread of a systemic infection. In a significant proportion of cases, an etiology cannot be identified. Clinical presentation is highly variable and routine laboratory testing lacks sensitivity. As such, a high degree of clinical suspicion is necessary for prompt diagnosis and intervention. Computed tomography and magnetic resonance imaging offer a timely and sensitive method of assessing for abscess. Appearance of abscess on routine imaging lacks specificity and will not spare biopsy in cases where the clinical context does not unequivocally indicate infectious etiology. Current work with advanced imaging modalities may yield more accurate methods of differentiation of mass lesions in the brain. Management of abscess demands a multimodal approach. Surgical intervention and medical therapy are necessary in most cases. Prognosis of brain abscess has improved significantly in the recent decades although close follow-up is required, given the potential for long-term sequelae and a risk of recurrence. PMID:25360205

  4. Gas-Forming Pyogenic Liver Abscess with Septic Shock

    PubMed Central

    Ishaq, Muhammad K.; Jones, Kellie R.

    2015-01-01

    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. PMID:26090240

  5. Brain abscess: Current management

    PubMed Central

    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

  6. Gas-forming liver abscess associated with rapid hemolysis in a diabetic patient

    PubMed Central

    Kurasawa, Miwa; Nishikido, Takashi; Koike, Junko; Tominaga, Shin-ichi; Tamemoto, Hiroyuki

    2014-01-01

    We experienced a case of liver abscess due to Clostridium perfringens (CP) complicated with massive hemolysis and rapid death in an adequately controlled type 2 diabetic patient. The patient died 6 h after his first visit to the hospital. CP was later detected in a blood culture. We searched for case reports of CP septicemia and found 124 cases. Fifty patients survived, and 74 died. Of the 30 patients with liver abscess, only 3 cases survived following treatment with emergency surgical drainage. For the early detection of CP infection, detection of Gram-positive rods in the blood or drainage fluid is important. Spherocytes and ghost cells indicate intravascular hemolysis. The prognosis is very poor once massive hemolysis occurs. The major causative organisms of gas-forming liver abscess in diabetic patients are Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli). Although CP is relatively rare, the survival rate is very poor compared with those of K. pneumoniae and E. coli. Therefore, for every case that presents with a gas-forming liver abscess, the possibility of CP should be considered, and immediate aspiration of the abscess and Gram staining are important. PMID:24748935

  7. Hematogenous Pasteurella multocida brain abscess

    SciTech Connect

    Wallace, M.; Lipsky, B.A.

    1985-10-01

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

  8. Posttraumatic Brain Abscess Caused by Aeromonas hydrophila

    PubMed Central

    Khumalo, Amanda; Kiratu, Erastus; Mlisana, Koleka

    2014-01-01

    Posttraumatic brain abscesses are usually caused by Gram-negative bacilli, notably Enterobacteriaceae and Staphylococcus aureus. Although Aeromonas hydrophila is a recognized cause of trauma-related sepsis, it has not been previously isolated from posttraumatic brain abscesses. We describe the first case of Aeromonas hydrophila brain abscess. PMID:24622098

  9. Brain abscess secondary to dental braces.

    PubMed

    Wolf, Joshua; Curtis, Nigel

    2008-01-01

    We report a case of Haemophilus aphrophilus brain abscess presenting 6 weeks after application of dental braces in an adolescent patient with a formerly undetected patent foramen ovale. Neither brain abscess nor invasive H. aphrophilus infection has previously been associated with dental braces. Application or tightening of dental braces may cause bacteremia and invasive disease from oral commensals. PMID:18162951

  10. Listeria monocytogenes: brain abscess or meningoencephalitis?

    PubMed

    Lechtenberg, R; Sierra, M F; Pringle, G F; Shucart, W A; Butt, K M

    1979-01-01

    A brain abscess caused by Listeria monocytogenes developed in an immunosuppressed renal transplant patient. Meningitis and meningoencephalitis from this organism were encountered in three other renal transplant recipients at this medical center during the past 4 years. Focal neurologic deficits occurred in patients with either Listeria abscess or meningoencephalitis. Computerized tomography was a rapid aid to the diagnosis of abscess. Immunosuppression has increased the incidence of central nervous system Listeria infections, but ampicillin still provides effective treatment, even when immunosuppressive therapy is continued. Limited experience with Listeria brain abscess suggests that surgical intervention improves the prognosis. PMID:370686

  11. Chronic abscess of the brain stem

    PubMed Central

    Russell, J. A.; Shaw, M. D. M.

    1977-01-01

    The incidence of solitary brain stem abscess is less than 4% of all posterior fossa abscesses, and probably less than 1% of all intracranial abscesses. Two cases are reported, both presenting as chronic progressive clinical problems and initially diagnosed as gliomas. It is suggested that aspiration is a more suitable treatment than excision, and that in cases secondary to otogenic disease, radical mastoidectomy might have been an adequate method of prophylaxis. Images PMID:303282

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

    PubMed

    Zhou, Zhaowei; Wuppalapati, Siddhartha; Scott, Nigel

    2015-06-01

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

  13. Brain abscess: Heuristics, principles, pathobiology, practice.

    PubMed

    Kothari, Manu; Goel, Atul; Muzumdar, Dattatraya

    2015-01-01

    Brain abscess is an uncommon but a compelling reality in neurosurgical practice. Its focal, local, and systemic manifestations conceal its infective and obsessive nature. There are many a lesson that a brain abscess, as a bio-phenomenon, offers to the medical fraternity in general and the neurosurgeons, in particular. From Skt. puyati = to stink, comes the word "pus," meaning something foul, putrid, or rotten. From ab = away, and cedre = to go, comes the term "abscess" which is but nature's ingenious way of creating a fluid-filled cavity that will eventually rupture to an exterior to get rid of the non-self contents and proceed to healing. A brain abscess is special in the sense that it is, in general, more solid than fluid for reasons the human body and brain know best. PMID:26053804

  14. INFLAMMATORY INDEX AND TREATMENT OF BRAIN ABSCESS

    PubMed Central

    OYAMA, HIROFUMI; KITO, AKIRA; MAKI, HIDEKI; HATTORI, KENICHI; NODA, TOMOYUKI; WADA, KENTARO

    2012-01-01

    ABSTRACT This study retrospectively analyzed 12 patients with brain abscesses. Half of the patients were diagnosed inaccurately in the initial stage, and 7.2 days were required to achieve the final diagnosis of brain abscess. The patients presented only with a moderately elevated leukocyte count, serum CRP levels, or body temperatures during the initial stage. These markers changed, first with an increase in the leukocyte count, followed by the CRP and body temperature. The degree of elevation tended to be less prominent, and the time for each inflammatory index to reach its maximum value tended to be longer in the patients without ventriculitis than in those with it. The causative organisms of a brain abscess were detected in 10 cases. The primary causative organisms from dental caries were Streptococcus viridians or milleri, and Fusobacterium nucleatum. Nocardia sp. or farcinica were common when the abscess was found in other regions. The primary causative organisms of unrecognized sources of infection were Streptococcus milleri and Prolionibacterium sp. Nocardia is resistant to many antibiotics. However, carbapenem, tetracycline and quinolone were effective for Nocardia as well as many other kinds of bacteria. In summary, the brain abscesses presented with only mildly elevated inflammatory markers of body temperature, leukocyte and CRP. These inflammatory markers were less obvious in the patients without ventriculitis and/or meningitis. The source of infection tended to suggest some specific primary causative organism. It was reasonable to initiate therapy with carbapenem. PMID:23092104

  15. Four cases of nocardial brain abscess

    PubMed Central

    Tamarit, Martin; Poveda, Pedro; Barón, Manuel; Del Pozo, Jose Manuel

    2012-01-01

    Background: Nocardial brain abscesses are a rare central nervous system infection with high morbidity and mortality. Infection is acquired through inhalation or direct innoculation and then spreads hematogenously. They are usually associated with immunocompromised patients but may appear in otherwise healthy individuals. Treatment is based on surgical aspiration and antibiotics for several months. Case Description: We present four cases of nocardial brain abscesses treated at our institution and review the literature regarding these lesions. Ages ranged from 22 to 71 years. One patient was a healthy individual without any predisposing condition. Patients were treated with surgical evacuation and long term parenteral antibiotics. Two patients made a full recovery; one patient died and one recovered with significant morbidity. In one case malignancy was suspected, probably delaying diagnosis. Conclusions: Nocardial brain abscesses are a rare condition that needs to be considered in the differential diagnosis of brain lesions. They are not necessarily associated with predisposing factors such as immunosupresion. Treatment must be started as soon as possible with surgical evacuation and long term parenteral antibiotics in order to avoid significant morbidity. PMID:23050202

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

    PubMed Central

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

    2015-01-01

    Brain abscesses caused by Nocardia are rare but have a very high mortality and specific requirements of antibiotic treatment. Nocardial brain abscesses are mainly found in patients with predisposing conditions such as pulmonary alveolar proteinosis (PAP), a disease associated with chronic exposure to silica dust. We present a case of multiple nocardial brain abscesses in a man with PAP probably due to long-term occupational exposure to silica dust. Conclusively, in patients presenting brain abscesses and a history of chronic exposure to silica dust, PAP and opportunistic nocardial infection should always be considered as possible diagnoses. PMID:26605224

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

    PubMed

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

    2013-03-01

    Streptococcus intermedius is a member of the Streptococcus anginosus group, also known as the Streptococcus milleri group. Although this is a commensal agent of the mouth and upper airways, it has been recognized as an important pathogen in the formation of abscesses. However, it has rarely been involved in the formation of brain abscess in children. We report 4 pediatric cases of brain abscess caused by S. intermedius. Three boys and 1 girl, all aged over 2 years, were admitted for a febrile meningeal syndrome and seizures, caused by a S. intermedius brain abscess. Diagnosis was obtained by brain imaging combined with culture of cerebrospinal fluid. The outcome was favorable after antibiotic therapy and abscess puncture. S. intermedius should be considered a potential pathogen involved in the development of brain abscess in children. PMID:23375710

  18. Successful Treatment of Multifoci Nocardial Brain Abscesses

    PubMed Central

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

    2015-01-01

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

  19. Toxic levels of ammonia in human brain abscess.

    PubMed

    Dahlberg, Daniel; Ivanovic, Jugoslav; Hassel, Bjørnar

    2016-03-01

    OBJECT Brain abscesses could lead to cerebral symptoms through tissue destruction, edema, changes in brain architecture, and increased intracranial pressure. However, the possibility that the pus itself could contribute to symptoms has received little attention. Brain abscesses are areas of tissue destruction, proteolysis, and formation of free amino acids, which are energy substrates for bacteria and possible sources of ammonia. Ammonia is neurotoxic, may cause brain edema, and could contribute to the symptoms of brain abscesses. METHODS The authors analyzed the extracellular phase of pus from 14 patients with brain abscesses with respect to ammonia and amino acids. For comparison, CSF from 10 patients undergoing external ventricular drainage was included. The ammonia-forming ability of Streptococcus intermedius and Staphylococcus aureus, two common microbial isolates in brain abscesses, was studied in vitro. RESULTS In brain abscesses ammonia was 15.5 mmol/L (median value; range 1.7-69.2 mmol/L). In CSF ammonia was 29 μmol/L (range 17-55 μmol/L; difference from value in pus: p < 0.001). The total concentration of amino acids in brain abscesses was 1.12-16 times higher than the ammonia concentration (p = 0.011). The median glucose value in pus was 0 mmol/L (range 0-2.1 mmol/L), lactate was 21 mmol/L (range 3.3-26.5 mmol/L), and pH was 6.8 (range 6.2-7.3). In vitro, S. intermedius and S. aureus formed ammonia at 6-7 mmol/L in 24 hours when incubated with 20 proteinogenic amino acids plus g-aminobutyric acid (GABA), taurine, and glutathione at 1 mmol/L. CONCLUSIONS Intracerebral abscesses contain toxic levels of ammonia. At the concentrations found in pus, ammonia could contribute to the brain edema and the symptoms of brain abscesses. PMID:26274996

  20. [Probable amebic brain abscess in a homosexual man with an Entamoeba histolytica liver abscess].

    PubMed

    Yamasaki, Masayoshi; Taniguchi, Akira; Nagai, Moritaka; Sasaki, Ryogen; Naito, Yutaka; Kuzuhara, Shigeki

    2007-10-01

    A 51-year-old Japanese-Brazilian homosexual man was admitted to a hospital because of fever, headache and right epigastralgia. He had been homosexual for 20 years. An abdominal CT revealed a liver abscess and microscopic examination of the pus of the drainage revealed cystic forms of Entamoeba histolytica. Oral administration of metronidazole 2,250 mg/day was started for amebic liver abscess. He complained of severe throbbing headache, and magnetic resonance imaging (MRI) of the brain showed a brain mass of approximately 2 cm in diameter in the right parietooccipital lobe. An amebic brain abscess was suspected and he was transferred to our hospital. Continuous oral administration of metronidazole for 49 days instead of invasive procedures gradually improved headache, fever and right epigastralgia. On the follow-up MRIs, the brain mass was gradually encapsulated, reduced its size, and finally disappeared. A diagnosis of amebic brain abscess was made on the basis of coexistent amebic liver abscess, MRI findings and a dramatic effectiveness to metronidazole. One should pay attention to E. Histolytica infection in the differential diagnosis of the abscess of the liver and brain since it has been increasing in Japan in recent years. PMID:18095503

  1. Management of brain abscesses. II: Antibiotics and computed tomography.

    PubMed

    Simpson, Donald

    2013-12-01

    The discovery of the sulphonamides in 1935 was followed by the dramatic introduction of penicillin, first used in the management of a brain abscess in 1942 by J.B. Pennybacker of Oxford. He integrated antimicrobial drugs in a system of diagnosis, local and systemic antibiotics, and operative treatment, which was widely accepted. However, the mortality from brain abscess remained high until the advent of computerized tomography in 1973 made diagnosis safe and easy. During the next two decades, Pennybacker’s system of management was modified, and applied with better results to all forms of brain abscess, including opportunistic infections associated with impaired immunity. These modifications have been studied historically in the management of 140 patients with brain abscesses treated in South Australia in the years 1955-95. PMID:24358478

  2. Scedosporium apiospermum brain abscesses in an immunocompetent man with silicosis.

    PubMed

    Wilson, Heather L; Kennedy, Karina J

    2013-03-01

    We report a case of Scedosporium apiosporum brain abscesses in an immunocompetent 69-year-old man with a history of silicosis. Delayed diagnosis and institution of antifungal therapy was associated with neurological impairment, with subsequent complications resulting in death, highlighting the need for early diagnostic aspiration of brain abscesses non-responsive to antibiotics. We propose that, in the absence of identifiable immunosuppression, silicosis may have been a contributing factor to the development of central nervous system infection. PMID:24432222

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

    PubMed Central

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

    2015-01-01

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

  4. A Case of Otogenic Brain Abscess Causing Loss of Consciousness

    PubMed Central

    Kwak, Min Kyu; Lee, Seung Hwan; Park, Chul Won

    2014-01-01

    Acute or chronic otitis media can cause intracranial complications, one of the most serious being brain abscess. Empirical antibiotic treatment and proper surgical management should be considered to avoid fatal consequences. However, proper extent and optimal timing of surgical intervention are still matters of debate. We present a case of a 31-year-old man who presented with acutely altered mental status, caused by otogenic brain abscess who we treated successfully with antibiotics and otologic surgery and no neurosurgical treatment. PMID:25279229

  5. Nocardia abscessus brain abscess in an immunocompetent host.

    PubMed

    Al Tawfiq, Jaffar A; Mayman, Talal; Memish, Ziad A

    2013-06-01

    Nocardia brain abscesses typically occur in immunocompromised patients. Most cases of nocardiosis are caused by the Nocardia asteroides complex and Nocardia brasiliensis. Here, we present a patient with a Nocardia abscessus brain abscess. The diagnosis was confirmed by DNA sequencing, and the organism was susceptible to linezolid, clarithromycin, ceftriaxone, imipenem, tobramycin, amikacin, minocycline and sulfamethoxazole. The patient was successfully treated medically in combination with surgical excision. PMID:23668458

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

    PubMed

    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. PMID:27085200

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

    PubMed

    Morita, Keiichi; Fukuzawa, Hiroaki; Maeda, Kosaku

    2015-12-01

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

  8. Scedosporium apiospermum causing brain abscess in a renal allograft recipient.

    PubMed

    Sharma, Amit; Singh, Divya

    2015-11-01

    Scedosporium apiospermum is the asexual form of a rare fungus Pseudallescheria boydii that is usually present in the soil, sewage and dirty water. In immunocompromised patients, it is a rare infection involving multiple organs. We present a case of renal allograft recipient who developed fever two weeks post renal transplant. He was initially found to have dengue fever. After five days, he became drowsy and developed right-sided hemiparesis. Magnetic resonance imaging of the brain revealed multiple irregular masses with associated edema consistent with fungal brain abscesses. Left parietal abscess was drained and he was started on voriconazole. His cyclosporine was stopped. Drained pus revealed fungal hyphae on potassium hydroxide stain and Scedosporium apiospermum on culture. Unfortunately, the patient died after five days. Scedosporium infections should be kept as a possibility in transplant recipients with disseminated infections, especially with a brain abscess. Despite antifungal therapy and surgical drainage, mortality rates are high. PMID:26586067

  9. Brain abscess mimicking brain metastasis in breast cancer.

    PubMed

    Khullar, Pooja; Datta, Niloy R; Wahi, Inderjeet Kaur; Kataria, Sabeena

    2016-03-01

    61year old female presented with chief complaints of headache for 30days, fever for 10days, altered behavior for 10days and convulsion for 2days. She was diagnosed and treated as a case of carcinoma of left breast 5years ago. MRI brain showed a lobulated lesion in the left frontal lobe. She came to our hospital for whole brain radiation as a diagnosed case of carcinoma of breast with brain metastasis. Review of MRI brain scan, revealed metastasis or query infective pathology. MR spectroscopy of the lesion revealed choline: creatinine and choline: NAA (N-Acetylaspartate) ratios of ∼1.6 and 1.5 respectively with the presence of lactate within the lesion suggestive of infective pathology. She underwent left fronto temporal craniotomy and evacuation of abscess and subdural empyema. Gram stain showed gram positive cocci. After 1month of evacuation and treatment she was fine. This case suggested a note of caution in every case of a rapidly evolving space-occupying lesion independent of the patient's previous history. PMID:26616913

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

    PubMed Central

    2010-01-01

    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. PMID:20423506

  11. [Syringomyelia appearing in a short term after brain abscess].

    PubMed

    Matsumoto, H; Masuo, O; Kuwata, T; Moriwaki, H; Ozaki, F; Nakai, K; Itakura, T

    1997-03-01

    We describe a rare case of syringomyelia that developed within only 4 months after the cure of the focal cerebritis and abscess. An 18-year-old man who had suffered from meningitis and brain abscess 1.5 years before, presented with pain and sensory disturbance in his left shoulder. Magnetic resonance image (MRI) showed a syrinx formation extending from the upper cervical to the lower thoracic cord. Investigation by MRI during the course of the brain abscess had the appearance of posterior cerebellar arachnoid cyst 3 months after the onset of brain abscess and syrinx developed within 9 months. After posterior fossa decompression and reopening of the Magendie's foramen, his symptom and MRI abnormality improved after one month. In contrast to reported cases of syringomyelia following cerebritis, syrinx formation in our case appeared in relatively a short time. We speculated that basal arachnoiditis and the formation of posterior cerebellar arachnoid cyst caused syrinx formation in a short term after cerebritis. PMID:9058437

  12. Brain abscess caused by Brucella abortus and Staphylococcus aureus in a child.

    PubMed

    Kalelioğlu, M; Ceylan, S; Köksal, I; Kuzeyli, K; Aktürk, F

    1990-01-01

    A case of a 12-year-old male with Fallot's tetralogy and brain abscess due to Brucella and Staphylococcus is presented. The abscess was aspirated and Brucella abortus and Staphylococcus aureus were isolated. PMID:2127588

  13. Massive Parallel Sequencing Provides New Perspectives on Bacterial Brain Abscesses

    PubMed Central

    Wilhelmsen, Marianne Thulin; Skrede, Steinar; Meisal, Roger; Jakovljev, Aleksandra; Gaustad, Peter; Hermansen, Nils Olav; Vik-Mo, Einar; Solheim, Ole; Ambur, Ole Herman; Sæbø, Øystein; Høstmælingen, Christina Teisner; Helland, Christian

    2014-01-01

    Rapid development within the field of massive parallel sequencing (MPS) is about to bring this technology within reach for diagnostic microbiology laboratories. We wanted to explore its potential for improving diagnosis and understanding of polymicrobial infections, using bacterial brain abscesses as an example. We conducted a prospective nationwide study on bacterial brain abscesses. Fifty-two surgical samples were included over a 2-year period. The samples were categorized as either spontaneous intracerebral, spontaneous subdural, or postoperative. Bacterial 16S rRNA genes were amplified directly from the specimens and sequenced using Ion Torrent technology, with an average of 500,000 reads per sample. The results were compared to those from culture- and Sanger sequencing-based diagnostics. Compared to culture, MPS allowed for triple the number of bacterial identifications. Aggregatibacter aphrophilus, Fusobacterium nucleatum, and Streptococcus intermedius or combinations of them were found in all spontaneous polymicrobial abscesses. F. nucleatum was systematically detected in samples with anaerobic flora. The increased detection rate for Actinomyces spp. and facultative Gram-negative rods further revealed several species associations. We suggest that A. aphrophilus, F. nucleatum, and S. intermedius are key pathogens for the establishment of spontaneous polymicrobial brain abscesses. In addition, F. nucleatum seems to be important for the development of anaerobic flora. MPS can accurately describe polymicrobial specimens when a sufficient number of reads is used to compensate for unequal species concentrations and principles are defined to discard contaminant bacterial DNA in the subsequent data analysis. This will contribute to our understanding of how different types of polymicrobial infections develop. PMID:24671797

  14. Abscess

    MedlinePlus

    ... the skin. Bacteria commonly causing abscesses are Staphylococcus aureus and Streptococcus . These bacteria enter the skin through ... once appropriately treated. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of "staph" bacteria ...

  15. Abscess

    MedlinePlus

    An abscess is a collection of pus in any part of the body that, in most cases, causes swelling and inflammation around it. ... collect in the damaged tissue. During this process, pus forms. Pus is the buildup of fluid, living ...

  16. Abscess

    MedlinePlus

    ... En Español Making a Change – Your Personal Plan Hot Topics Meningitis Choosing Your Mood Prescription Drug Abuse ... compress by wetting a washcloth with warm — not hot — water and placing it over the abscess for ...

  17. Successful neuroendoscopic treatment of intraventricular brain abscess rupture.

    PubMed

    Nishizaki, Takafumi; Ikeda, Norio; Nakano, Shigeki; Sakakura, Takanori; Abiko, Masaru; Okamura, Tomomi

    2011-07-01

    Intraventricular rupture of a brain abscess is still associated with a high mortality rate. Here, we report such a case in a patient with normal immunity that was treated successfully using neuroendoscopic approach. A 69-year-old man who had presented with headache and fever developed confusion and restlessness. Magnetic resonance imaging revealed a mass with ring enhancement extending to the right ventricle. Emergency aspiration of cerebrospinal fluid (CSF) from the spinal canal revealed severe purulent meningitis. Bacterial culture of the CSF and blood was negative. Because of prolonged consciousness disturbance, the patient underwent evacuation of the intraventrcular abscess using a neuroendoscope. The pus was centrifuged and collected for bacterial culture, and this revealed Streptococcus intermedius/milleri. After implantation of a ventricular catheter, gentamicin sulfate was administered twice a day for 9 days. Cefotaxime sodium was also administered intravenously for 14 days, followed by oral administration of cefcapene pivoxil hydrochloride for 10 days. The patient made a complete recovery, and was discharged 31 days after admission. After 20 months of follow-up, he is doing well and has returned to his work. In cases of intraventricular rupture of a brain abscess, a neuroendoscopic approach is useful for evacuation of intraventricular debris or septum, and identification of the causative bacterium for selection of antibiotics, possibly reducing the period of hospitalization. PMID:24765313

  18. Vancomycin penetration of a brain abscess: case report and review of the literature

    SciTech Connect

    Levy, R.M.; Gutin, P.H.; Baskin, D.S.; Pons, V.G.

    1986-05-01

    A 56-year-old man developed an abscess within a right parietal cystic anaplastic astrocytoma 3 days after removal of iodine-125 sources placed 9 days earlier for interstitial radiation therapy. After treatment with cephalosporin antibiotics proved unsuccessful, the patient was treated with intravenous vancomycin and intermittent percutaneous drainage of the abscess. Vancomycin levels obtained from the brain abscess fluid, both before and during later operative removal of the abscess, were 15 and 18 micrograms/ml, respectively; the serum vancomycin level was 21 micrograms/ml. This is the first report of the excellent penetration of vancomycin into brain abscess fluid.

  19. Drastic Therapy for Listerial Brain Abscess Involving Combined Hyperbaric Oxygen Therapy and Antimicrobial Agents

    PubMed Central

    Nakahara, Keiichi; Ideo, Katsumasa; Shindo, Seigo; Suga, Tomohiro; Ueda, Akihiko; Honda, Shoji; Hirahara, Tomoo; Watanabe, Masaki; Yamashita, Taro; Maeda, Yasushi; Yonemochi, Yasuhiro; Takita, Tomohiro; Ando, Yukio

    2014-01-01

    Background Listeria monocytogenes (L. monocytogenes) is a rare causative pathogen of brain abscess that is often found in immunocompromised patients. Although patients with supratentorial listerial abscesses showed a longer survival with surgical drainage, the standard therapy for patients with subtentorial lesions has not been established. Case Report We report herein a patient with supra- and subtentorial brain abscesses caused by L. monocytogenes infection. These abscesses did not respond to antibiotics, and his symptoms gradually worsened. Drainage was not indicated for subtentorial lesions, and the patient was additionally treated with hyperbaric oxygen therapy, which dramatically reduced the volume of abscesses and improved the symptoms. Conclusions This is the first report of drastic therapy for a patient with listerial brain abscesses involving combined antibiotics and hyperbaric oxygen therapy. The findings suggest that hyperbaric oxygen therapy is a good option for treating patients with deep-seated listerial abscesses and for who surgical drainage is not indicated. PMID:25324887

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

    PubMed Central

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

    2015-01-01

    Background: A brain stem abscess is a rare and severe medical condition. Here, we present a rare case of a brain stem abscess in a young pregnant woman, requiring acute stereotactic intervention. Case Description: A 36-year-old woman presented with a headache, nausea, and vomiting, and computed tomography showed a space-occupying lesion in the brain stem. She became shortly after comatose, and we decided to perform an acute stereotactic aspiration of the abscess. Soon after surgery, her neurological condition improved dramatically. Conclusion: A brainstem abscess is a life-threatening condition with a potentially good outcome if treated adequately. PMID:26543670

  1. Multiple Brain Abscesses due to Streptococcus anginosus: Prediction of Mortality by an Imaging Severity Index Score

    PubMed Central

    2016-01-01

    An elderly patient with altered mental status, brain abscesses, ventriculitis, and empyemas died of septic shock and brain abscesses secondary to Streptococcus anginosus despite aggressive treatment. An imaging severity index score with a better prognostic value than the Glasgow coma scale predicted mortality in this patient. PMID:27034878

  2. Brain abscess due to Listeria monocytogenes: case report and literature review.

    PubMed

    Dee, R R; Lorber, B

    1986-01-01

    Listeria monocytogenes is an uncommon cause of brain abscess. Of a total of 14 cases of L. monocytogenes brain abscess (one described for the first time and 13 reported previously in the English-language literature), seven (50%) occurred in patients with leukemia and recipients of renal transplants; four (29%) of the cases occurred in previously healthy individuals. Common clinical findings were similar to those in brain abscess due to other causes and included fever (57%), headache (57%), and focal neurologic signs (64%). Distinctive, however, was the unusually high frequency of associated meningitis and bacteremia; blood cultures were positive in all eight cases in which they were performed. Eight (57%) of the 14 patients died. L. monocytogenes should be included in the differential diagnosis of brain abscess in patients with leukemia and in renal transplant recipients. Listerial brain abscess is highly unlikely when blood culture results are negative. PMID:3099364

  3. Potential nosocomial acquisition of epidemic Listeria monocytogenes presenting as multiple brain abscesses resembling nocardiosis

    PubMed Central

    Stefanovic, Aleksandra; Reid, James; Nadon, A Celine; Grant, Jennifer

    2010-01-01

    Listerial brain abscesses are rare, and are found mostly in patients with underlying hematological malignancies or solid-organ transplants. A case of a patient with Crohns disease and multiple brain abscesses involving the left cerebellum and right sylvian fissure is described. The Gram stain and histopathology of the cerebellar abscess revealed Gram-positive, beaded rods suggestive of Nocardia. However, on culture, Listeria monocytogenes was identified. Listeria may appear Gram-variable and has been misidentified as streptococci, enterococci and diphtheroids. The present case is the first reported case of L monocytogenes resembling Nocardia on both microbiological and histopathological assessment. Reported cases of listerial brain abscesses are sporadic, while the current case was part of a nationwide listerial outbreak linked to consumption of contaminated deli meats. Broad antimicrobial therapy (including antilisterial coverage) in immunosuppressed patients presenting with brain abscess is crucial, until cultures confirm the identification of the organism. PMID:21358887

  4. Propionibacterium Acnes Brain Abscess in an Immunocompetent Man in the Absence of Prior Neurosurgery.

    PubMed

    Odunukan, Olufunso W; Masannat, Fares; Baka, J Jeff

    2016-02-01

    Propionibacterium acnes is a rare, but established, cause of intracranial abscesses. We describe a case of P. acnes brain abscess in an immunocompetent man without prior neurosurgery. A 49-year old man with mild psoriasis presented with a two-week history of gait changes, generalized weakness and a two-day history of headaches, aphasia and confusion. Imaging revealed a left thalamic mass and surgical biopsy suggested a pyogenic abscess. Cultures of biopsy samples of the abscess grew P. acnes alone. MRI and serial neurological exam showed marked clinical improvement with intravenous antibiotics. The significant reduction in the abscess was sustained on MRI obtained at six weeks after completion of antibiotic therapy. In conclusion, P. acnes must be considered as a differential diagnosis in individuals presenting with features suggestive of a brain abscess even in the absence of immunosuppression or previous neurosurgery. PMID:26999913

  5. A rare case of Trichosporon brain abscess, successfully treated with surgical excision and antifungal agents.

    PubMed

    Basiri, Keivan; Meidani, Mohsen; Rezaie, Farshid; Soheilnader, Shabnam; Fatehi, Farzad

    2012-01-01

    Trichosporonosis is an acute, sometimes fatal infection with the potential capability of disseminating to multiple deep organs. More than 100 cases of trichosporonosis have been described, particularly in patients with neutropenia or haematological malignancies. In 1970, Watson et al. described the first case of brain trichosporonosis; the patient died 4 weeks after admission. Herein, we describe a 34-year-old man with a history of autoimmune hepatitis, hypothyroidism, and alopecia totalis, treated with corticosteroids, who was admitted with left lower limb weakness. Brain MRI revealed a diffuse brain lesion in the right frontoparietal area mimicking a brain abscess. After resection of the lesion, Trichosporon asahii was isolated from the abscess. Further treatment with antifungal agents resulted in improvement in clinical status. To the best of our knowledge, this is the second case of Trichosporon brain abscess since the first description in 1970 and the first case of successful treatment of Trichosporon brain abscess. PMID:22426768

  6. Group G Streptococci in association with brain abscess: a rare occurrence.

    PubMed

    Subramani, Parimala; Raja, Vidhya; Lingaiah, Bipinchandra Bhagath; Madappa, Beena Prasavangada; Chakravarthy, Hariprakash

    2014-11-01

    Brain abscess is a serious life-threatening infection of the brain parenchyma. We are reporting a rare case of brain abscess caused by Group G Streptococcus in a 12 year-old female child who presented with neurological symptoms. She was diagnosed with congenital anomalies of the heart at birth. She was treated with amoxyclav and ciprofloxacin. The child recovered and was discharged uneventfully. PMID:25390063

  7. Neonatal Brain Abscess due to Extended-Spectrum Beta-Lactamase Producing Klebsiella pneumoniae.

    PubMed

    Biswas, Biswajit; Mondal, Monojit; Thapa, Rajoo; Mallick, Debkrishna; Datta, Asok Kumar

    2014-11-01

    Klebsiella pneumoniae (K. pneumoniae) causing brain abscess in newborn infants is rare. Presented herein, is a 27-day-old male neonate who developed two frontal lobe abscesses in association with K. pneumoniae sepsis and meningitis. Antibiotic susceptibility testing utilizing the double-disk synergy method (Cefotaxime and Amoxycillin-Clavulanate) confirmed the extended spectrum beta-lactamase (ESBL) production by the isolate. He was treated simultaneously with antibiotics (Meropenem and Amikacin) and abscess aspiration through the anterior fontanelle, with less than satisfactory outcome. ESBL producing K. pneumoniae brain abscess in neonates is extremely rare in the English literature. Emperical carbapenems and aminoglycoside coverage in neonates with K. pneumoniae sepsis and brain abscess, especially in areas with high rate of ESBL producing bacteria may be warranted. PMID:25584278

  8. Encephalitozoon cuniculi genotype I as a causative agent of brain abscess in an immunocompetent patient.

    PubMed

    Ditrich, Oleg; Chrdle, Ales; Sak, Bohumil; Chmelík, Václav; Kubále, Jirí; Dyková, Iva; Kvác, Martin

    2011-07-01

    A brain abscess caused by Encephalitozoon cuniculi genotype I together with Streptococcus intermedius occurred in a patient without major immunocompromise and with diabetes. The distinguishing clinical signs were hemiparesis and epilepsy. The microsporidium was observed in the abscess aspirate, and its specific DNA was also detected in stool and urine. The patient was successfully treated with albendazole and mebendazole. PMID:21593268

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

    PubMed

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

    2016-03-01

    Brain abscesses are frequently caused by poly-microbial conditions. Comparatively, brain abscesses caused by Prevotella species are very rare. Right-to-left cardiac shunting due to a patent foramen ovale may predispose patients to infection. We report an isolated Prevotella brain abscess that occurred in a healthy, young, male patient with a patent foramen ovale. The patient did not have a clinically obvious odontogenic source of infection, and no other distant extracranial infectious sources were observed. The patient was successfully treated with stereotactic aspiration and antibiotics. PMID:26851526

  10. Microascus cinereus (Anamorph Scopulariopsis) Brain Abscess in a Bone Marrow Transplant Recipient

    PubMed Central

    Baddley, John W.; Moser, Stephen A.; Sutton, Deanna A.; Pappas, Peter G.

    2000-01-01

    We report the first documented case of brain abscess due to the dematiaceous fungus Microascus cinereus, an organism common in soil and stored grain. M. cinereus was isolated from brain abscess material from a bone marrow transplant recipient. The patient responded well to treatment by amphotericin B lipid complex, itraconazole, and a craniotomy but later died from secondary complications caused by graft-versus-host disease. PMID:10618123

  11. A brain abscess of probable odontogenic origin in a child with cyanotic heart disease.

    PubMed

    Moskovitz, Moti; Birenboim, Ravit; Katz-Sagi, Hadas; Perles, Zeev; Averbuch, Diana

    2012-01-01

    The purpose of the present report was to present a rare case of a brain abscess in a child with heterotaxy syndrome, severe cardiac anomalies, and extensive dental caries. The pathogen was Streptococcus intermedius isolated from the cerebrospinal fluid. The source of the pathogen was probably an infection of a primary molar with a dentoalveolar abscess involving the bud of the permanent successor. After a long course of antibiotic regimens followed by a craniotomy with abscess drainage, a shunt, and comprehensive dental treatment, the patient was discharged from the hospital without any neurological sequel. At home, she completed an additional 3 months of oral antibiotics. This is the only known documented case of a toddler with a brain abscess of probable odontogenic origin without previous dental intervention. It emphasizes the importance of collaboration between cardiologists and pediatric dentists, especially in referring children with congenital heart defects for early dental checkups. PMID:23211917

  12. A Case of Brain Abscess Caused by Medication-Related Osteonecrosis of the Jaw

    PubMed Central

    Yamagata, Kenji; Nagai, Hiroki; Baba, Osamu; Uchida, Fumihiko; Kanno, Naomi; Hasegawa, Shogo; Yanagawa, Toru; Bukawa, Hiroki

    2016-01-01

    Reports of brain abscesses caused by medication-related osteonecrosis of the jaw (MRONJ) are very rare. We here present the case of a 76-year-old man with terminal-stage prostatic carcinoma and a brain abscess caused by MRONJ at the maxilla. The patient had been treated with zoledronic acid and denosumab for bone metastasis. For the brain abscess, an antibiotic regimen based on ceftriaxone and metronidazole and a sequestrectomy contributed to a successful outcome. In the case of maxillary MRONJ extending to the maxillary sinus, active resection of the infected bone should be considered to prevent the spread of the infection beyond the maxillary sinus, into the ethmoid sinus, and into the brain. PMID:26949551

  13. A Case of Brain Abscess Caused by Medication-Related Osteonecrosis of the Jaw.

    PubMed

    Yamagata, Kenji; Nagai, Hiroki; Baba, Osamu; Uchida, Fumihiko; Kanno, Naomi; Hasegawa, Shogo; Yanagawa, Toru; Bukawa, Hiroki

    2016-01-01

    Reports of brain abscesses caused by medication-related osteonecrosis of the jaw (MRONJ) are very rare. We here present the case of a 76-year-old man with terminal-stage prostatic carcinoma and a brain abscess caused by MRONJ at the maxilla. The patient had been treated with zoledronic acid and denosumab for bone metastasis. For the brain abscess, an antibiotic regimen based on ceftriaxone and metronidazole and a sequestrectomy contributed to a successful outcome. In the case of maxillary MRONJ extending to the maxillary sinus, active resection of the infected bone should be considered to prevent the spread of the infection beyond the maxillary sinus, into the ethmoid sinus, and into the brain. PMID:26949551

  14. Brain Abscess in a Rhesus Macaque (Macaca mulatta) with a Cephalic Implant

    PubMed Central

    Leblanc, Mathias; Berry, Kristy; McCort, Holly; Reuter, Jon D

    2013-01-01

    We report a case of brain abscess after craniotomy and the placement of a recording chamber for electrophysiologic records in an adult rhesus macaque (Macaca mulatta) enrolled in visual research. Approximately 2 wk after surgery, the macaque presented with nonspecific gastrointestinal signs and showed no evidence of fever, neurologic deficits, increased intracranial pressure, suggestive alterations in the CBC, or abnormal changes in the recording chamber. The macaque responded to symptomatic and antibiotic treatment and showed no behavioral or abnormal clinical signs for 3 wk before collapsing suddenly. The macaque was euthanized, and pathologic evaluation revealed a large brain abscess immediately under the original craniotomy. PMID:24209974

  15. A rare case of multilocus brain abscess due to Entamoeba histolytica infection in a child.

    PubMed

    Tamer, Gülden S; Öncel, Selim; Gökbulut, Sevil; Arisoy, Emin S

    2015-03-01

    Brain abscess due to Entamoeba histolytica (E. histolytica) may pose a diagnostic problem or a therapeutic challenge, as evidenced by the paucity of papers reporting complete recovery after treatment. An 11-year-old girl presented with progressive drowsiness, diminished movements of the left upper limb, and swallowing problems. Cranial MRI showed multiple, contrast-dense masses with fluid content. She was started on meropenem. Surgical drainage was performed. No bacterial or fungal growth was observed in drainage samples. Entamoeba histolytica trophozoites were detected in the tissue sample. Intravenous metronidazole was started and continued for 6 weeks, at the end of which abscesses were found and to have shrunk considerably. Intravenous therapy was switched to oral metronidazole, which was continued for 2 weeks. She regained all her preexisting abilities. Multiple brain abscesses due to E. histolytica is a very rare occurrence, and histopathologic evaluation is important in diagnosis. PMID:25737180

  16. Brevibacterium casei as a Cause of Brain Abscess in an Immunocompetent Patient ▿

    PubMed Central

    Kumar, V. Anil; Augustine, Deepthi; Panikar, Dilip; Nandakumar, Aswathy; Dinesh, Kavitha R.; Karim, Shamsul; Philip, Rosamma

    2011-01-01

    Coryneform bacteria belonging to the genus Brevibacterium have emerged as opportunistic pathogens. Of the nine known species of Brevibacterium isolated from human clinical samples, Brevibacterium casei is the most frequently reported species from clinical specimens. We report the first case of B. casei brain abscess in an immunocompetent patient successfully treated by surgery and antimicrobial therapy. PMID:22012007

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

    PubMed Central

    Pelaez, Ana Isabel; del Mar Garcia-Suarez, Maria; Manteca, Angel; Melon, Ovidio; Aranaz, Carlos; Cimadevilla, Rafael; Mendez, Francisco Javier; Vazquez, Fernando

    2009-01-01

    We report on a rare case of pulmonary Nocardiosis and brain abscess caused by Nocardia otitidiscaviarum in an elderly woman with chronic obstructive pulmonary disease. Taxonomic identification involved phenotypic testing, restriction fragment length polymorphism (RFLP), and complete 16S rRNA gene sequencing. PMID:19366439

  18. Minocycline Modulates Neuroinflammation Independently of Its Antimicrobial Activity in Staphylococcus aureus-Induced Brain Abscess

    PubMed Central

    Kielian, Tammy; Esen, Nilufer; Liu, Shuliang; Phulwani, Nirmal K.; Syed, Mohsin M.; Phillips, Napoleon; Nishina, Koren; Cheung, Ambrose L.; Schwartzman, Joseph D.; Ruhe, Jorg J.

    2007-01-01

    Minocycline exerts beneficial immune modulatory effects in several noninfectious neurodegenerative disease models; however, its potential to influence the host immune response during central nervous system bacterial infections, such as brain abscess, has not yet been investigated. Using a minocycline-resistant strain of Staphylococcus aureus to dissect the antibiotic’s bacteriostatic versus immune modulatory effects in a mouse experimental brain abscess model, we found that minocycline significantly reduced mortality rates within the first 24 hours following bacterial exposure. This protection was associated with a transient decrease in the expression of several proinflammatory mediators, including interleukin-1β and CCL2 (MCP-1). Minocycline was also capable of protecting the brain parenchyma from necrotic damage as evident by significantly smaller abscesses in minocycline-treated mice. In addition, minocycline exerted anti-inflammatory effects when administered as late as 3 days following S. aureus infection, which correlated with a significant decrease in brain abscess size. Finally, minocycline was capable of partially attenuating S. aureus-dependent microglial and astrocyte activation. Therefore, minocycline may afford additional therapeutic benefits extending beyond its antimicrobial activity for the treatment of central nervous system infectious diseases typified by a pathogenic inflammatory component through its ability to balance beneficial versus detrimental inflammation. PMID:17717149

  19. Clinical Pathway in the Treatment of Nocardial Brain Abscesses following Systemic Infections

    PubMed Central

    Zheng, Yun-Cong; Hsu, Jee-Ching; Hsu, Yung-Hsing; Hsu, Wen-Hsing; Kwan, Aij-Lie

    2014-01-01

    Nocardial infections are commonly encountered in patients with immunocompromised states. Cerebral nocardiosis is an uncommon clinical entity, representing only 2% of all cerebral abscesses. It has a higher mortality rate, especially for multiple cerebral lesions in immunocompromised hosts following systemic infections. However, an optimal treatment policy to deal with these immunocompromised patients in Asia is still lacking. We retrospectively reviewed the subjects with nocardial brain abscesses from 2001 to 2011 at our medical center. All of them had multiple brain abscesses, underlying with immunocompromised state following systemic infections. All cases were under steroid control due to their comorbidities for more than six months. The comorbidities and misdiagnosis often lead to poor prognosis. The change in the environments of the microorganisms caused by immunosuppressive agents and multiple antibiotic uses may play an important role in this critical disorder. Aggressive craniotomy should be performed in time to avoid grievous neurological outcomes. Our conclusion is that early diagnosis and appropriate antibiotic uses should be implemented promptly, and aggressive craniotomy should be performed for nocardial brain abscesses in subjects with systemic infections under an immunocompromised status. PMID:25254126

  20. Brain Abscess following Rituximab Infusion in a Patient with Pemphigus Vulgaris

    PubMed Central

    Al-Harbi, Talal M.; Muammer, Shahad A.; Ellis, Ronald J.

    2015-01-01

    Patient: Female, 52 Final Diagnosis: Brain abscess Symptoms: Fever • headache • weakness, left sided Medication: Prednisolone • Azathioprine • Rituximab Clinical Procedure: Stereotactic brain biopsy and LP Specialty: Neurology Objective: Rare disease Background: Immunocompromised patients are at increased risk for developing meningitis or, rarely, brain abscess with opportunistic organisms like Listeria monocytogenes. Case Report: A 52 year-old Saudi Arabian woman who was diagnosed with pemphigus vulgaris and diabetes and had been on prednisolone and azathioprine for about 4 years. She presented with headache, low-grade fever, and left-sided weakness 2 weeks after receiving the second dose of rituximab infusion. Magnetic resonance imaging revealed an enhanced space-occupying lesion with multiple small cyst-like structures and vasogenic edema in the right temporoparietal area. Her blood culture was positive for Listeria monocytogenes, and a brain biopsy showed necrotic tissues with pus and inflammatory cells. She recovered after a 6-week course of antibiotics with ampicillin and gentamycin. Conclusions: Brain abscess due to Listeria monocytogenes is a risk that should be considered when adding rituximab to the regimen of a patient who is already Immunocompromised. PMID:25659437

  1. Anorectal abscess

    MedlinePlus

    ... abscess; Rectal abscess; Perirectal abscess; Perianal abscess; anal gland abscess; Abscess - anorectal ... Common causes of anorectal abscess include: Blocked glands in the ... rectal abscesses may be caused by intestinal disorders such as ...

  2. The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in the Treatment of Brain Abscess

    PubMed Central

    Lee, Sang-Woo; Kang, Dong-Hun; Hwang, Jeong-Hyun; Sung, Joo-Kyung; Hwang, Sung-Kyoo

    2011-01-01

    Objective The purpose of this study was to evaluate whether 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used to assess the therapeutic response of brain abscess. Methods A study was conducted on 10 consecutive patients with brain abscess. Magnetic resonance imaging (MRI) with diffuse-weighted imaging (DWI) was performed at 3 and 6 weeks after surgical treatment and intravenous antibiotics therapy and FDG-PET at 6 weeks after treatment. The extent of the abscess, signal changes on MRI, and FDG-PET standardized uptake values were analyzed and correlated with the response to therapy. Results Aspiration or craniotomy with excision of the abscess followed by intravenous antibiotics for 6-8 weeks resulted in good recovery with no recurrence. In 10 patients, two had low signal intensity on the DWI; one had no uptake on FDG-PET imaging after 6 weeks antibiotics and discontinued intravenous treatment, but the other patient had diffuse, increased uptake on FDG-PET imaging after 6 weeks antibiotics and underwent an additional 2 weeks of intravenous antibiotics. The remaining eight patients had high signals on the DWI. Four had no uptake on FDG-PET imaging and the treatment period varied from 6 to 8 weeks (mean, 6.75 weeks). Among the other four patients, FDG was accumulated in a diffuse or local area corresponding to a high signal area within the DWI and 2 weeks of intravenous antibiotics was added. Conclusion MRI plus FDG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy. PMID:21716900

  3. [Multiple brain abscesses in the territory of the vertebral-basilar artery resulting from an infected aortic arch graft].

    PubMed

    Otani, Yoshihiro; Inoue, Satoshi; Kawauchi, Satoshi; Uneda, Atsuhito; Kajitani, Takumi; Watanabe, Kyoichi; Deguchi, Kentaro; Kiriyama, Hideki; Tokunaga, Koji; Matsumoto, Kengo

    2015-03-01

    A 62-year-old man with high fever and in a state of disorientation was transferred to our hospital. One year before this transfer, he had undergone total arch replacement surgery for thoracic aortic dissection. On admission to our hospital, head MRI revealed multiple brain abscesses in the territory of the vertebral-basilar artery, and chest CT showed gas around the aortic graft, in particular, at the origin of the left subclavian artery. We diagnosed him with brain abscesses in the left vertebral-basilar artery resulting from an infected aortic graft. We immediately began administration of intravenous antibiotics. Although his blood, urine, and cerebrospinal fluid cultures were negative, fortunately, the brain abscesses and ectopic gas disappeared. Since reports of only antibiotic use for treating brain abscesses due to aortic graft infection are rare, the appropriate duration of antibiotic administration has not been established yet. Therefore, careful observation is required in this case. PMID:25748809

  4. Uncorrected Ebstein's anomaly with atrial septal defect complicated by brain abscess in an adult patient.

    PubMed

    Scarsini, Roberto; Prioli, Maria A; Milano, Elena G; Benetti, Valentina; Rebonato, Micol; Puppini, Giovanni; Alessandrini, Franco; Vassanelli, Corrado

    2014-06-28

    We report the case of a 56-year-old male patient affected by a severe form of Ebstein's anomaly (type C of Carpentier classification) with secundum atrial septal defect, who presented to the emergency department with impaired consciousness, seizures, and trismus. The brain computed tomography scan showed evidence of a mass located in the frontal lobe, confirmed by brain MRI consistent with brain abscess. Both echocardiography and cardiac MRI showed no evidence of valvular vegetation. This case shows how the combination of increased atrial pressure and bidirectional shunt through atrial septal defect may lead to paradoxical embolization. PMID:24979119

  5. Scedosporium aurantiacum brain abscess after near-drowning in a survivor of a tsunami in Japan.

    PubMed

    Nakamura, Yutaka; Suzuki, Naomi; Nakajima, Yoshio; Utsumi, Yu; Murata, Okinori; Nagashima, Hiromi; Saito, Heisuke; Sasaki, Nobuhito; Fujimura, Itaru; Ogino, Yoshinobu; Kato, Kanako; Terayama, Yasuo; Miyamoto, Shinya; Yarita, Kyoko; Kamei, Katsuhiko; Nakadate, Toshihide; Endo, Shigeatsu; Shibuya, Kazutoshi; Yamauchi, Kohei

    2013-12-01

    Many victims of the tsunami that occurred following the Great East Japan Earthquake on March 11, 2011 developed systemic disorders owing to aspiration pneumonia. Herein, we report a case of tsunami lung wherein Scedosporium aurantiacum was detected in the respiratory tract. A magnetic resonance image of the patient's head confirmed multiple brain abscesses and lateral right ventricle enlargement. In this case report, we describe a potential refractory multidrug-resistant infection following a tsunami disaster. PMID:24238227

  6. Central condylar displacement with brain abscess from chronic mandibular osteomyelitis.

    PubMed

    Lee, Thomas; Green, Ross; Hsu, Jack

    2013-06-01

    In this case report, we describe a unique long-term complication from undiagnosed mandibular osteomyelitis. A 53-year-old female who underwent a dental extraction complicated by chronic postoperative odontogenic infection and cutaneous parotid fistula formation 2 years earlier presented with acute mental status change, gradual unilateral facial nerve palsy (House-Brackmann score V), and nontraumatic dislocation of the condylar head into the middle cranial fossa. The patient's chronic mandibular osteomyelitis led to glenoid fossa erosion, middle cranial fossa penetration, and temporal lobe abscess formation. A combined middle cranial fossa approach through a burr hole placed in the squamous temporal bone near the zygomatic root and intraoral mandibular approach to ipsilateral condylar head was performed to complete partial mandibulectomy, including condylectomy. The patient was treated with 6 weeks of meropenem perioperatively. Four months after the surgery, the patient had complete resolution of skull base osteomyelitis, parotid fistula, and neurologic deficits and full recovery of facial nerve function (House-Brackmann score of I). PMID:23315680

  7. [Brain abscesses after extracranial infections of the head and neck area].

    PubMed

    Marchiori, C; Tonon, E; Boscolo Rizzo, P; Vaglia, A; Meyding-Lamadé, U; Levorato, M; Da Mosto, M C; Dietz, A

    2003-10-01

    The authors report on 20 immunocompetent patients with brain abscess after 12 cases of middle ear, seven tooth and a single frontal sinus infection. The clinical aspects, hematochemical and microbiological data, the role of imaging diagnostics (CT, MR) and the type of treatment are analysed. Neurosurgery was performed on 17 patients (85%), eight of whom subsequently underwent evacuation of the primary source of infection (four mastoidectomies, two timpanoplasties, two tooth extractions). Mastoidectomy was eventually carried out on one of the three patients who did not undergo neurosurgery. Microbiological diagnosis was possible in nine patients through culture examination: Proteus mirabilis in three cases, Peptostreptococcus sp. in two, Micrococcus varians, Proteus vulgaris, Streptococcus sanguis and Streptococcus viridans not typed in single cases. The pus was sterile in eight patients (47.1% of those operated). An association of two antimicrobial agents was used in 18 patients, while in two cases monotherapy was preferred, based on the isolated bacteria. Treatment lasted on average 38 days. The most frequently used therapy regimen (75%) was the association of a beta-lactam drug with chloramphenicol or metronidazole. Therapy was successful in 19/20 patients; one patient died. There was no significant difference in prognostic terms with regard to sex, age, duration of symptoms prior to diagnosis, clinical picture at onset, number and size of abscesses or type of treatment. Recognising the first clinical signs and symptoms (headache, fever, alterations in consciousness, focal neurological deficit, epileptic seizures) is extremely important for prompt diagnosis of brain abscess. PMID:14523535

  8. Microbiological Spectrum of Brain Abscess at a Tertiary Care Hospital in South India: 24-Year Data and Review

    PubMed Central

    Lakshmi, V.; Umabala, P.; Anuradha, K.; Padmaja, K.; Padmasree, C.; Rajesh, A.; Purohit, A. K.

    2011-01-01

    Intracranial abscesses are life-threatening infections that pose a diagnostic challenge not only to the neurosurgeon but also to the microbiologists. Detailed studies documenting the spectrum of infecting agents involved in brain abscesses are limited from India. Materials and Methods. This is a retrospective analysis of 352 samples from 1987 to 2010 analyzed at a tertiary care hospital in South India from 1987 to 2010, to document the changing trends with time. Results. The age of the patients ranged from 2 to 80 years, a larger number of males being affected. Otogenic infections were the most common cause while cryptogenic abscesses were 20%. Gram stain and culture positivity were 78% each. Gram-positive and negative facultative aerobes and obligate anaerobes were also on the rise. Unusual organisms, like Burkholderia pseudomallei, Salmonella typhi, Nocardia species, Cladosporium bantiana, Fonsecaea pedrosoi, Entamoeba histolytica, and Acanthamoeba were also isolated and/or detected from the brain abscesses aspirate or resected tissue. Summary. New and emerging pathogens associated with brain abscess, especially in immunosuppressed individuals, have renewed the necessity of an early detection, and it will be of great value in appropriate management of patients with brain abscess. PMID:22191080

  9. Brain abscess as the initial presentation of a macroprolactinoma: Case report.

    PubMed

    Rubio-Almanza, Matilde; Cámara-Gómez, Rosa; de San Román-Mena, Laila Pérez; Simal-Julián, Juan Antonio; Ramos-Prol, Agustín; Botella-Asunción, Carlos; Merino-Torres, Juan Francisco

    2015-01-01

    Macroprolactinomas may behave invasively and infiltrate the skull base, causing a subsequent thinning that can also lead to a bone defect and a direct route of entry for pathogens. We describe the case of a 34-year-old male admitted to hospital with fever (38°C), headache, stiffness in the neck, diplopia and neurological impairment. Brain magnetic resonance imaging showed two bilateral abscesses in the fronto-parietal areas with intracranial venous sinus thrombosis and a pituitary adenoma that extended from the suprasellar region, eroding the sellar floor into the sphenoid sinus. Laboratory hormone measurements showed increased levels of prolactin and low levels of FSH, LH and testosterone. The patient received antibiotic treatment and surgery was performed. The patient developed central deafness as a neurological deficit. It is advisable to include pituitary adenoma in the differential diagnosis of meningitis even though its onset as intracranial abscess and rectus sinus thrombosis is extremely rare. PMID:25487178

  10. [Disseminated Nocardiosis Complicated by Multiple Brain Abscesses: A Case Report].

    PubMed

    Koh, Masaki; Tomita, Takahiro; Kashiwazaki, Daina; Ashizawa, Nobuyuki; Yamamoto, Yoshihiro; Kuroda, Satoshi

    2015-12-01

    We report a relatively rare case of a disseminated type of nocardiosis without lung involvement. A 75-year-old man developed moderate fever and disturbed consciousness and was admitted to our hospital. Laboratory examinations revealed signs of inflammation. Chest X-rays indicated no abnormalities, but brain MRI showed ring-like enhancement lesions in the right temporal and left frontal lobes. Similar lesions were identified in the left kidney and right leg. The brain lesions were purulent and were surgically irrigated. Gram- and Kinyoun-positive bacteria were identified, and the patient was diagnosed as suffering from a disseminated type of nocardiosis without lung involvement. He was treated with trimethoprim-sulfamethoxazole for over 10 months. The postoperative course was uneventful, and he was discharged without any neurological sequelae two months after surgery. Kinyoun staining was important in early diagnosis and hence providing appropriate therapy for life-threatening nocardiosis. PMID:26646175

  11. Aspergillus flavus-Induced Brain Abscess in an Immunocompetent Child

    PubMed Central

    Al-Maskari, Nawal; Hussain, Ibrahim; Jumaa, Suleiman; Al-Shail, Essam A.

    2016-01-01

    Intracranial aspergillosis is an extremely rare manifestation of invasive aspergillosis in immunocompetent children and is associated with high morbidity and mortality. We report a 12-year-old immunocompetent male child who was referred to the King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, in May 2010 after a sudden-onset headache and loss of consciousness. Brain imaging revealed a large right space-occupying occipital lesion and the patient underwent a craniotomy and resection. Histopathology of the lesion revealed necrotising granulomatous fungal encephalitis with many hyphae engulfed by multinucleated giant histiocytes. Two days later, a computed tomography scan showed debulking of the fungal mass and the patient was discharged on oral voriconazole. However, imaging at a six-week follow-up showed progression of the abnormality. A residual or persistent fungal brain lesion was suspected. Further neurosurgical resection of the lesion was performed and cultures showed growth of Aspergillus flavus. The patient was treated successfully with antifungal therapy over the following two years. PMID:27226920

  12. Brain abscess due to Cladophialophora bantiana: a review of 124 cases.

    PubMed

    Chakrabarti, Arunaloke; Kaur, Harsimran; Rudramurthy, Shivaprakash M; Appannanavar, Suma B; Patel, Atul; Mukherjee, Kanchan K; Ghosh, Anup; Ray, Ujjwayini

    2016-02-01

    Brain abscess caused by Cladophialophora bantiana is a rare disease associated with high mortality due to delay in diagnosis and absence of standardized therapy. We reviewed 124 culture proven C. bantiana brain abscess cases; 103 cases published in English literature during 1952 through 2014 and 21 unpublished cases from our reference center. The majority (57.3%) of the patients was from Asian countries especially from India (62/124, 50%). The diagnosis of the cases was delayed with mean duration 115 days after developing symptoms. The disease was nearly equally distributed in immunocompetent and immunosuppressed hosts but associated with significantly higher mortality (77.1%) in later group. Complete excision of brain lesion in immunocompetent host led to significantly better survival (43.7%). Though all commercially available antifungal drugs have been used in these patients, amphotericin B deoxycholate or lipid preparations were most commonly (62.83%) prescribed agent. None of the drugs used was found to be independently associated with improved outcome. In vitro antifungal susceptibility testing of 13 isolates of our center, demonstrated good activity to voriconazole, posaconazole, and itraconazole, but these triazoles were prescribed in only 29.2% patients. Increased awareness with early suspicion of the disease, and aggressive medical and surgical approach in treating these patients may improve the outcome. PMID:26483430

  13. A case report of Mycoplasma hominis brain abscess identified by MALDI-TOF mass spectrometry.

    PubMed

    Pailhoriès, H; Rabier, V; Eveillard, M; Mahaza, C; Joly-Guillou, M-L; Chennebault, J-M; Kempf, M; Lemarié, C

    2014-12-01

    We report the case of a 43-year-old man with a Mycoplasma hominis brain abscess occurring after a cranial trauma, which was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The presence of colonies on classic blood agar plates and the use of MALDI-TOF MS, a valuable diagnostic tool that identified M. hominis due to its presence in the VITEK MS database, allowed the rapid diagnosis of this infection. PMID:25449252

  14. Association of ICAM-1 (K469E) and MCP-1 -2518 A>G gene polymorphism with brain abscess.

    PubMed

    Mishra, Priyanka; Prasad, Kashi Nath; Singh, Kamini; Sahu, Rabi Narayan; Ojha, Bal Krishna

    2016-03-15

    Brain abscess develops in response to a parenchymal infection. Intercellular adhesion molecule-1 (ICAM-1) and monocyte chemoattractant protein-1 (MCP-1) play vital role in central nervous system (CNS) diseases. We studied ICAM-1 (K469E) and MCP-1 (-2518 A>G) polymorphisms among brain abscess patients. The genotypic distributions of ICAM-1 (K469E) and MCP-1 (-2518 A>G) were significantly different between patients and controls. Further, patient with predisposing factors, and also with culture result, we found significant association. The study revealed that the polymorphisms of these molecules lead to increased production, which appears to be a risk for the development of brain abscess. PMID:26943967

  15. Multiple Brain Abscesses Due to Aspergillus Fumigatus in a Patient With Liver Cirrhosis

    PubMed Central

    Tang, Hung-Jen; Liu, Wei-Lun; Chang, Tsung Chain; Li, Ming-Chi; Ko, Wen-Chien; Wu, Chi-Jung; Chuang, Yin-Ching; Lai, Chih-Cheng

    2016-01-01

    Abstract Invasive cerebral aspergillosis always developed in immunocompromised host. Early diagnosis may save life in this critical condition; however, it is difficult to reach. Herein, we presented an unusual case of invasive cerebral aspergillosis in a cirrhotic patient. A 47-year-old man presented with progressive deterioration of consciousness for three days. The patient had a history of alcoholic liver cirrhosis, Child-Pugh class C. Magnetic resonance imaging (MRI) of brain showed multi-focal parenchymal lesions, which was consistent with multiple brain abscesses. The diagnosis of invasive cerebral aspergillosis was made by molecular based laboratory methods including Aspergillus galactomannan antigen assay and oligonucleotide array. Despite treatment with the antifungal agent, Amphotericin B, the patient died at the ninth day of hospitalization. Our findings suggest that liver cirrhosis can be one of risk factors of invasive cerebral aspergillosis, and support the diagnosing usefulness of MRI, Aspergillus galactomannan antigen assay, and oligonucleotide array. PMID:26945363

  16. Multiple Brain Abscesses Due to Aspergillus Fumigatus in a Patient With Liver Cirrhosis: A Case Report.

    PubMed

    Tang, Hung-Jen; Liu, Wei-Lun; Chang, Tsung Chain; Li, Ming-Chi; Ko, Wen-Chien; Wu, Chi-Jung; Chuang, Yin-Ching; Lai, Chih-Cheng

    2016-03-01

    Invasive cerebral aspergillosis always developed in immunocompromised host. Early diagnosis may save life in this critical condition; however, it is difficult to reach. Herein, we presented an unusual case of invasive cerebral aspergillosis in a cirrhotic patient.A 47-year-old man presented with progressive deterioration of consciousness for three days. The patient had a history of alcoholic liver cirrhosis, Child-Pugh class C. Magnetic resonance imaging (MRI) of brain showed multi-focal parenchymal lesions, which was consistent with multiple brain abscesses. The diagnosis of invasive cerebral aspergillosis was made by molecular based laboratory methods including Aspergillus galactomannan antigen assay and oligonucleotide array. Despite treatment with the antifungal agent, Amphotericin B, the patient died at the ninth day of hospitalization.Our findings suggest that liver cirrhosis can be one of risk factors of invasive cerebral aspergillosis, and support the diagnosing usefulness of MRI, Aspergillus galactomannan antigen assay, and oligonucleotide array. PMID:26945363

  17. MRI with Magnetic Resonance Spectroscopy of multiple brain abscesses secondary to Scedosporium apiospermum in two immunocompromised patients.

    PubMed

    Slone, H Wayne; Kontzialis, Marinos; Kiani, Bahram; Triola, Craig; Oettel, David J; Bourekas, Eric C

    2013-01-01

    Scedosporium apiospermum is a deadly fungal infection that can infect the central nervous system, particularly in immunocompromised patients. We present two cases of Scedosporium brain abscesses. The first case was fatal and relevant conventional MRI and MR spectroscopy findings are discussed. To our knowledge, this is the first reported case of MR spectroscopy in Scedosporium apiospermum abscesses. In the second case, the patient recovered and conventional MR findings are followed over several months. In the appropriate clinical setting, conventional MR imaging and MR spectroscopy may facilitate diagnosis, earlier initiation of antifungal pharmacotherapy and surgical intervention in this frequently fatal infection. PMID:23465993

  18. Chloramphenicol Toxicity Revisited: A 12-Year-Old Patient With a Brain Abscess

    PubMed Central

    Wiest, Donald B.; Cochran, Joel B.; Tecklenburg, Fred W.

    2012-01-01

    Chloramphenicol, a broad-spectrum antibiotic, is rarely used in the United States due to its well-described adverse effects. Because of its limited use, many clinicians are unfamiliar with its indications, spectrum of activity, and potential adverse drug effects. We describe a 12-year-old patient who presented after two craniotomies for a persistent brain abscess complicated by long-term chloramphenicol administration. Findings for this patient were consistent with many of the adverse drug effects associated with chloramphenicol, including elevated chloramphenicol serum concentrations, anemia, thrombocytopenia, reticulocytopenia, and severe metabolic acidosis. Rare manifestations of chloramphenicol toxicity that developed in this patient included neutropenia, visual field changes, and peripheral neuropathy. Chloramphenicol administration was discontinued, and hemodialysis was initiated for severe metabolic acidosis. The patient recovered with severe visual field deficits. Although chloramphenicol is rarely indicated, it remains an effective antibiotic. Healthcare providers should become familiar with the pharmacology, toxicology, and monitoring parameters for appropriate use of this antibiotic. PMID:23118672

  19. A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China

    PubMed Central

    2014-01-01

    Background Brain abscesses continue to pose diagnostic and therapeutic challenges in developed and developing countries. Their aetiology and management remain complex and unclear, making improvement of treatments and outcome difficult. Methods To determine the demographics, management, and the variables that affect the outcome in subjects with brain abscesses treated at a single centre over an 11-year period, we retrospectively analysed data in 60 patients with brain abscesses surgically treated with stereotactically guided aspiration or open craniotomy excision in Shanghai Changzheng Hospital between January 2001 and December 2011. Such variables as age, gender, Glasgow Coma Scale (GCS) score at admission, clinical presentation, location, number of lesions, predisposing factors, mechanism of infection, aetiological agent, and therapy were analysed independently. Results Our analysis demonstrated that patient age and gender were factors that influence the occurrence of brain abscess; female patients and patients greater than 40 years of age were most likely to suffer a brain abscess. We also found that a patient’s GCS score upon admission did not influence outcome. While frequency of successful culturing of the infectious agent was low, positive cultures were obtained in only 8 of the cases (13.33%), in which the most common isolate was Streptococcus milleri. Outcome was favourable in 78.33% of the subjects, while the mortality rate was 20%. The outcome of one patient was poor due to the abscess in the basal ganglia region. Conclusions Stereotactically guided aspiration is an effective treatment for brain abscess with an overall favourable outcome. Mortality due to brain abscess was not directly related to surgery nor surgical technique. Additional studies will continue to reveal patients trends that may improve treatment for brain abscess. PMID:24903315

  20. Acrophialophora fusispora Brain Abscess in a Child with Acute Lymphoblastic Leukemia: Review of Cases and Taxonomy

    PubMed Central

    Al-Mohsen, I. Z.; Sutton, D. A.; Sigler, L.; Almodovar, E.; Mahgoub, N.; Frayha, H.; Al-Hajjar, S.; Rinaldi, M. G.; Walsh, T. J.

    2000-01-01

    A 12-year-old girl with acute lymphoblastic leukemia was referred to King Faisal Specialist Hospital and Research Center. The diagnosis without central nervous system (CNS) involvement was confirmed on admission, and chemotherapy was initiated according to the Children Cancer Group (CCG) 1882 protocol for high-risk-group leukemia. During neutropenia amphotericin B (AMB) (1 mg/kg of body weight/day) was initiated for presumed fungal infection when a computed tomography (CT) scan of the chest revealed multiple nodular densities. After 3 weeks of AMB therapy, a follow-up chest CT revealed progression of the pulmonary nodules. The patient subsequently suffered a seizure, and a CT scan of the brain was consistent with infarction or hemorrhage. Because of progression of pulmonary lesions while receiving AMB, antifungal therapy was changed to liposomal AMB (LAMB) (6 mg/kg/day). Despite 26 days of LAMB, the patient continued to have intermittent fever, and CT and magnetic resonance imaging of the brain demonstrated findings consistent with a brain abscess. Aspiration of brain abscess was performed and the Gomori methenamine silver stain was positive for hyphal elements. Culture of this material grew Acrophialophora fusispora. Lung biopsy showed necrotizing fungal pneumonia with negative culture. The dosage of LAMB was increased, and itraconazole (ITRA) was added; subsequently LAMB was discontinued and therapy was continued with ITRA alone. The patient demonstrated clinical and radiological improvement. In vitro, the isolate was susceptible to low concentrations of AMB and ITRA. A. fusispora is a thermotolerant, fast-growing fungus with neurotropic potential. We report the first case of human infection involving the CNS. Acrophialophora resembles Paecilomyces but differs in having colonies that become dark and in the development of phialides along the sides or at the tips of echinulate brown conidiophores. Conidia are borne in long chains and are smooth or ornamented with fine-to-coarse echinulations, sometimes in spiral bands. The taxonomy of the genus Acrophialophora is reviewed, and Acrophialophora nainiana and Acrophialophora levis are considered as synonyms of A. fusispora. PMID:11101597

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

    PubMed

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

    2015-09-01

    Skull base endoscopy in the treatment of brain abscesses has been rarely published. Moreover, endoscopic endonasal transethmoidal approach (EETA) for the treatment of brain abscess following a head trauma has been reported only in a few case reports. We report the management of a patient of intracerebral abscess and reconstruction of the accompanying anterior skull base defect through an EETA.Thirty-year-old male with a frontal lobe abscess due to a penetrating skull base trauma was operated via EETA. After drainage of the abscess, dural and bony defects were repaired to prevent any recurrence. Postoperative radiological imaging revealed prominent decrease in abscess size. The patient did not need any further surgical intervention, and antibiotherapy was adequate.EETA is safe and effective in the management of brain abscesses. Skull base endoscopy provides direct visualization of the abscess cavity through a minimal invasive route, facilitates wide exposure of surrounding neurovascular structures within the operative field, and enables concurrent closure of the skull base defect. PMID:26335317

  2. Brain Abscesses Caused by Nocardia paucivorans in a Multiple Myeloma Patient Treated with Lenalidomide and Dexamethasone: a Case Report and Review of Literature

    PubMed Central

    Monticelli, Jacopo; Luzzati, Roberto; Maurel, Cristina; Rosin, Chiara; Valentinotti, Romina; Farina, Claudio

    2015-01-01

    We report the first case of multiple brain abscesses caused by Nocardia paucivorans in a patient suffering from multiple myeloma on treatment with lenalidomide and dexamethasone. N. paucivorans is a recently described species of the genus Nocardia, which is supposed to have a heightened neurotropism in cases of disseminated infection. Although nocardiosis itself is an uncommon infectious complication in multiple myeloma so far, nocardial brain abscess should be added to the spectrum of adverse effects due to this novel chemotherapy regimen. PMID:25574370

  3. Rapid brain death caused by a cerebellar abscess with Fusobacterium nucleatum in a young man with drug abuse: a case report

    PubMed Central

    2014-01-01

    Background Fusobacterium nucleatum is a strict anaerobic microorganism that causes disease entities such as periodontal and soft tissue abscesses, pulmonary and intraabdominal infections and very rarely intracerebral infections. Case presentation Here, we report the rare case of a previously healthy 25-year-old German man with a cerebellar abscess caused by Fusobacterium nucleatum that resulted in rapid brain death. Toxicological screening showed positivity for amphetamines and cannabis. The diagnosis was obtained by polymerase chain reaction amplification of bacterial deoxyribonucleic acid in cerebrospinal fluid. Conclusions In drug users clinicians should think about rare causes of brain abscesses/meningitis. Early diagnosis is necessary and justifies the use of molecular techniques. PMID:24915846

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

    PubMed Central

    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

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

    PubMed

    Oliveira, Anna Paula Romero de; Pappalardo, Mara Cristina; Dantas, Daniel; Lins, Diogo; Vidal, José Ernesto

    2016-01-01

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

  6. Treatment of a brain abscess caused by Scedosporium apiospermum and Phaeoacremonium parasiticum in a renal transplant recipient.

    PubMed

    Larbcharoensub, Noppadol; Chongtrakool, Piriyaporn; Wirojtananugoon, Chewarat; Watcharananan, Siriorn P; Sumethkul, Vasant; Boongird, Atthaporn; Jirasiritham, Sopon

    2013-05-01

    Cerebral mycosis is a significant cause of morbidity among immunocompromised populations. We present here a case of cerebral infection with Scedosporium apiospermum and Phaeoacremonium parasiticum in a 49-year-old renal transplant recipient. Fourteen years after renal transplantation, the patient presented with invasive pulmonary aspergillosis treated with intravenous liposomal amphotericin B. The patient had clinical and radiographic improvement. However, 6 weeks later, the patient presented with cerebral infection. Magnetic resonance imaging revealed multiple rim enhancing brain abscesses. Brain and cerebrospinal fluid cultures ultimately grew Scedosporium apiospermum and Phaeoacremonium parasiticum. The patient was treated with voriconazole for 6 months and had clinical and radiologic improvement. We believe this is the first reported case of co-infection of the brain with scedosporiosis and phaeohyphomycosis in a renal transplant recipient, who had received intravenous liposomal amphotericin B. Voriconazole may represent a new therapeutic option for these simultaneous infections in the brain. PMID:24050081

  7. On the report of the first successful surgical treatment of brain abscess in the Ottoman Empire by Dr. Cemil Topuzlu in 1891.

    PubMed

    Mut, Melike; Dinç, Gülten; Naderi, Sait

    2007-10-01

    IN 1891, Dr. Cemil Topuzlu operated on a brain abscess that originated as a complication of a depression fracture of the cranial inner table. The patient presented with Jacksonian seizures on his left side after a sharp trauma resulting in a 15 cm-long scalp laceration and underlying linear cranial fracture in the right parietal bone. Dr. Topuzlu attributed Jacksonian epilepsy to the fracture irritating the motor area in the right hemisphere and attempted a craniotomy based on his measurements to localize the Rolandic fissure. The operation was complicated by a brain abscess, and Dr. Topuzlu reoperated to drain the abscess. He successfully treated the brain abscess and Jacksonian seizures and then presented this case in the Royal Society of Medicine of the Ottoman Empire and in the International Surgery Congress in Lyon in 1894. The case report was published in his surgery book in 1905. The case was not only the first case of brain abscess to be treated successfully with surgical intervention in the Ottoman Empire, it was also one of the first cases of neurological surgery performed using contemporary anesthesiological and surgical techniques, which reveals the importance of neurological examination and cerebral localization techniques in the era before x-rays. Dr. Topuzlu was the founder of modern surgery in the Ottoman Empire and deserves to be credited for his novel applications in the 19th century. PMID:17986950

  8. [Huge brain abscess and invasive pulmonary disease by fungal infection during chemotherapy for infantile acute myeloid leukemia].

    PubMed

    Sato, Tomonobu; Suzuki, Daisuke; Ichikawa, Mizuho; Kaneda, Makoto; Nakagawa, Atsuko; Kobayashi, Ryoji; Ariga, Tadashi

    2007-12-01

    The authors encountered a 7-year-old girl with a huge brain abscess and invasive pulmonary lesion due to fungus, who had been treated for acute myelogenous leukemia (AML). Although she was administered voriconazole to prevent fungal infection, she developed partial seizure and paralysis of the left side because of the huge brain abscess. Fungus culture and serum fungal markers, including Aspergillus antigen, were all negative. She underwent drainage and surgical resection of necrotic tissue after antifungal agents, including liposomal amphotericin B (L-AMB). Resection pathology revealed localized fungal infection, suspected as due to zygomycosis. The cerebral lesion reduced after the operation and the pulmonary lesion also vanished. We discontinued AML treatment because of the severe fungal infection; however, she has remained in continuous remission. Although Lipo-AMPH and itraconazole are comparatively effective for zygomycosis, progressive disseminated zygomycosis is extremely intractable. Our case underlines the feasibility and successful application of combined conventional antifungal agents and surgical resection in such a patient. PMID:18203515

  9. Brain Abscesses Due to Aspergillus nidulans Infection During Induction Chemotherapy for Acute Lymphoblastic Leukemia.

    PubMed

    Sadarangani, Manish; Harvey, Melissa; McDonald, Allison; Speert, David P; Dix, David

    2015-08-01

    We present the case of a 3-year-old boy who was diagnosed with cerebral abscesses due to Aspergillus nidulans infection on day 28 of induction chemotherapy for acute lymphoblastic leukemia. He responded well to treatment with voriconazole and caspofungin, making a full recovery. There are very few cases of invasive aspergillosis reported in children during induction chemotherapy for acute leukemia and A. nidulans is rare in the absence of chronic granulomatous disease. PMID:25985238

  10. Two Rapidly Growing Mycobacterial Species Isolated from a Brain Abscess: First Whole-Genome Sequences of Mycobacterium immunogenum and Mycobacterium llatzerense

    PubMed Central

    Greninger, Alexander L.; Langelier, Charles; Cunningham, Gail; Keh, Chris; Melgar, Michael; Chiu, Charles Y.

    2015-01-01

    Rapidly growing mycobacteria are rarely found in central nervous system infections. We describe a case of polymicrobial infection in a brain abscess including two rapidly growing Mycobacterium species, M. immunogenum and M. llatzerense. The Mycobacterium isolates were distinguishable by molecular methods, and whole-genome sequencing showed <60% pairwise nucleotide identity. PMID:25926490

  11. [Brain Abscess due to Infection with Dematiaceous Fungi Cladophialophora bantiana Associated with Hypogammaglobulinemia Following Gastrectomy: A Case Report].

    PubMed

    Shimogawa, Takafumi; Sayama, Tetsuro; Haga, Sei; Akiyama, Tomoaki; Makihara, Kosuke; Morioka, Takato

    2016-01-01

    Dematiaceous fungi have melanin-like pigment in the cell wall and usually cause a variety of dermal infections in humans. Infections of the central nervous system(cerebral phaeohyphomycosis)are rare but serious, since they commonly occur in immunocompromized patients. A 76-year-old man was admitted with mild motor aphasia and underwent total excision of a mass in the left frontal lobe. With the postoperative diagnosis of brain abscess due to infection with dematiaceous fungi (C. bantiana) associated with hypogammaglobulinemia following gastrectomy, intravenous antifungal drugs including amphotericin B and fluconazole were administered. Regrowth of the abscess with intraventricular rupture was noted at about the 88th day after the initial surgery, and the patient underwent neuroendoscopic aspiration of the pus and placement of a ventricular drain. Following intraventricular administration of miconazole through ventricular drainage or an Ommaya reservoir, neuroradiological findings improved, but general and neurological conditions worsened. Further treatment was discontinued and the patient died 9 months after onset. The poor outcome in this patient is attributed to 1)intractability of dematiaceous fungi, 2)development of ventriculitis and the need for intraventricular administration of antifungal drugs, and 3)untreatable hypogammaglobulinemia following gastrectomy. PMID:26771098

  12. Perirenal abscess

    MedlinePlus

    ... The biggest risk factor for perirenal abscess is kidney stones , by blockage of urine flow. This provides a ... perirenal abscess should lead to a good outcome. Kidney stones must be treated to avoid further infections. In ...

  13. Peritonsillar Abscess

    MedlinePlus

    ... Plan Hot Topics Meningitis Choosing Your Mood Prescription Drug Abuse Healthy School Lunch ... What's in this article? What Is a Peritonsillar Abscess? What Causes Peritonsillar Abscesses? What Are the Signs Someone Has ...

  14. Salvage pneumonectomy for pulmonary arteriovenous malformation in a 12-year-old boy with brain abscess and hemiparesis: A fatal outcome

    PubMed Central

    Majumdar, Gauranga; Agarwal, Surendra Kumar; Pande, Shantanu; Chandra, Bipin

    2016-01-01

    Large pulmonary arteriovenous malformations (PAVMs) constitute an uncommon cause of central cyanosis with septic embolism and brain abscess. This large right to left shunt can lead to chronic severe hypoxemia and significant morbidity and mortality if untreated. Conservative parenchyma-sparing lung resection was used widely as treatment of choice. However, with the advent of embolotheraphy, it is considered the preferred mode of treatment with less invasiveness. We here report a 12-year-old boy with large aneurysmal pulmonary arteriovenous fistula presented with brain abscess and hemiparesis. He underwent thoracotomy and pneumonectomy for large PAVMs, and it was complicated with bleeding and massive blood transfusion. The patient developed acute renal failure as a postoperative complication and succumbed to it. We suggest proper look out for systemic collateral and their management by embolitheraphy either alone or in combination should be tried first. We also suggest median sternotomy and intrapericardial approach for pneumonectomy in such difficult situation can be helpful. PMID:27051111

  15. Intracranial blastomycotic abscess mimicking malignant brain neoplasm: Successful treatment with voriconazole and surgery

    PubMed Central

    Arora, Kanika; Dawkins, Ross L.; Bauer, David F.; Palmer, Cheryl A.; Hackney, James R.; Markert, James M.

    2015-01-01

    Background: Cerebral blastomycosis is a rarely reported disease, and in the absence of associated, underlying systemic infection, poses a great diagnostic difficulty. Magnetic resonance imaging can sometimes provide equivocal information when trying to pinpoint a diagnosis. Classically, cerebral blastomycosis has been treated with amphotericin B. Voriconazole is a newer triazole antifungal with potential as a follow-up treatment of blastomycosis of the central nervous system after initial therapy with amphotericin B. Case Description: We describe one such case of a cerebral blastomycotic abscess, presenting in the absence of any systemic disease, which was initially thought to be a neoplasm. It was successfully treated by surgical resection followed by sequential amphotericin B and voriconazole. The patient did well with voriconazole therapy and was followed for voriconazole tolerance with liver function tests, which continued to be stable at 8 months past the initiation of therapy. At 12 months postoperatively, the patient was doing well and showed gradual improvement in a visual field cut, with no sign of recurrent infection. Conclusions: Isolated cerebral blastomycosis can present a diagnostic challenge. In the absence of systemic infection, surgical resection followed by antifungal therapy is a logical treatment plan. PMID:26673672

  16. Use of FDG-PET to detect a chronic odontogenic infection as a possible source of the brain abscess.

    PubMed

    Sato, Jun; Kuroshima, Takeshi; Wada, Mayumi; Satoh, Akira; Watanabe, Shiro; Okamoto, Shozo; Shiga, Tohru; Tamaki, Nagara; Kitagawa, Yoshimasa

    2016-05-01

    This study describes the use of (18)F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to detect a chronic odontogenic infection as the possible origin of a brain abscess (BA). A 74-year-old man with esophageal carcinoma was referred to our department to determine the origin of a BA in his oral cavity. He had no acute odontogenic infections. The BA was drained, and bacteria of the Staphylococcus milleri group were detected. Whole body FDG-PET revealed that the only sites of definite uptake of FDG were the esophageal carcinoma and the left upper maxillary region (SUVmax: 4.5). These findings suggested that the BA may have originated from a chronic periodontal infection. Six teeth with progressive chronic periodontal disease were extracted to remove the possible source of BA. These findings excluded the possibility of direct spread of bacteria from the odontogenic infectious lesion to the intracranial cavity. After extraction, there was no relapse of BA. PMID:26497357

  17. Hepatic abscesses

    PubMed Central

    Rajagopalan, S.; Langer, V.

    2012-01-01

    Hepatic abscesses are potentially lethal diseases if early diagnosis and treatment are not instituted. They are prevalent all over the globe and pyogenic abscesses are predominant over amoebic. With better control of intra abdominal and systemic infections by a spectrum of antibiotics, aetiology of pyogenic abscesses are secondary to interventions and diseases in the biliary tree to a large extent today. The common organisms isolated are the Gram negative group. Amoebic abscesses continue to plague some regions of the world where hygiene and sanitation are questionable. Over the years, diagnosis, treatment and prognosis have evolved remarkably. Imaging modalities like ultrasonography and CT scan have become the cornerstone of diagnosis. The absence of ionizing radiation makes MRI an attractive alternative in patients who require multiple follow up scans. Serological testing in amoebic abscesses has become more reliable. Though antibiotics have remained the principal modality of management, percutaneous drainage of abscesses have vastly improved the chances of cure and bring down the morbidity drastically in pyogenic abscesses. Amoebic abscesses respond well to medical treatment with nitroimidazoles, and minimally invasive surgical drainage is an option in cases where open surgery is indicated. PMID:24532886

  18. Delayed Development of Brain Abscesses Following Stent-Graft Placement in a Head and Neck Cancer Patient Presenting with Carotid Blowout Syndrome

    SciTech Connect

    Oweis, Yaseen; Gemmete, Joseph J. Chaudhary, Neeraj; Pandey, Aditya; Ansari, Sameer

    2011-02-15

    We describe the delayed development of intracranial abscesses following emergent treatment with a covered stent-graft for carotid blowout syndrome (CBS) in a patient with head and neck cancer. The patient presented with hemoptysis and frank arterial bleeding through the tracheostomy site. A self-expandable stent-graft was deployed across a small pseudoaneurysm arising from the right common carotid artery (RCCA) and resulted in immediate hemostasis. Three months later, the patient suffered a recurrent hemorrhage. CT of the neck demonstrated periluminal fluid around the caudal aspect of the stent-graft with intraluminal thrombus and a small pseudoaneurysm. Subsequently, the patient underwent a balloon test occlusion study and endovascular sacrifice of the RCCA and right internal carotid artery. MRI of the brain demonstrated at least four ring-enhancing lesions within the right cerebral hemisphere consistent with intracranial abscesses that resolved with broad-spectrum antibiotic coverage.

  19. Pediatric intracranial abscesses.

    PubMed

    Bonfield, Christopher M; Sharma, Julia; Dobson, Simon

    2015-06-01

    Intracranial infections in children are a relatively rare, but potentially severe condition. Because of the potential for rapid deterioration, timely diagnosis and treatment are necessary. These infections are categorized based on their intracranial location: epidural abscess, subdural empyema, and brain abscess. They largely arise from direct extension of adjacent infection, hematogenous seeding, or trauma. Clinical presentations of intracranial infections also vary. However, common signs and symptoms include headache, fever, nausea and vomiting, altered mental status, focal neurologic deficits, and seizures. In general, MRI demonstrates a peripherally enhancing lesion with high signal on diffusion weighted imaging (DWI). Bacterial isolates vary, but most commonly are a single pathogen. Successful treatment requires a multidisciplinary team approach including such modalities as antibiotic therapy and surgical drainage. When possible, open surgical evacuation of the abscess is preferred, however, in cases of deep-seated lesions, or in unstable patients, aspiration has also been performed with good results. PMID:25917804

  20. Peritonsillar abscess

    MedlinePlus

    ... type of bacteria called group A beta-hemolytic streptococcus . Peritonsillar abscess most often occurs in older children, adolescents, and young adults. The condition is rare now that antibiotics are used to treat tonsillitis.

  1. Tooth abscess

    MedlinePlus

    ... tooth abscess is a collection of infected material (pus) in the center of a tooth. It is ... the tooth. Infection results in a collection of pus and tissue swelling within the tooth. This causes ...

  2. Potential consequences of essential drug shortages in Canada: Brain abscess due to Nocardia farcinica associated with dapsone prophylaxis for Pneumocystis jirovecii pneumonia

    PubMed Central

    Wuerz, Terry C; Bow, Eric J; Seftel, Matthew D

    2013-01-01

    In 2012, Canadian pharmacies experienced a shortage of trimethoprim-sulfamethoxazole tablets. Drug shortages may result in unintended clinical consequences such as infection with pathogens against which the alternative medication is ineffective. This is highlighted in the present article, which describes a case of brain abscess due to Nocardia species that developed while receiving dapsone as an alternative for prophylaxis against Pneumocystis jirovecii pneumonia in a highly immune-suppressed patient. Clinicians should be cognizant of these issues when prescribing alternative agents. PMID:24421828

  3. Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

    SciTech Connect

    Erol, Ilknur Cetin, I. Ilker; Alehan, Fuesun; Varan, Birguel; Ozkan, Sueleyman; Agildere, A. Muhtesem; Tokel, Kursad

    2006-06-15

    A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported.

  4. Retroperitoneal Abscess

    PubMed Central

    Oluwole, Soji F.; Adekunle, Ademakinwa; Akintan, Bade

    1983-01-01

    Perforated bowel or diseases of the retroperitoneal organs may be complicated by retroperitoneal abscess formation. Six cases of retroperitoneal abscess treated at Ife University Teaching Hospital, Ile-Ife, Nigeria, over a two-year period are reported. Delayed presentation was responsible for the only death in the series and was also associated with prolonged morbidity in the remaining five cases. Early presentation and diagnosis, use of appropriate antibiotics, and prompt surgical intervention are factors that appear to influence the morbidity of the disease. ImagesFigure 1Figure 2 PMID:6887273

  5. The importance of a proper aetiological diagnosis in the management of patients with invasive mycoses: a case report of a brain abscess by Scedosporium apiospermum.

    PubMed

    Caggiano, Giuseppina; Cantisani, Piero; Rolli, Marilena; Gianfreda, Cosimo Damiano; Pizzolante, Maria; Montagna, Maria Teresa

    2011-10-01

    Scedosporium apiospermum is a saprobic fungus responsible for many different clinical manifestations. Although it affects mostly immunocompromised patients, pulmonary and disseminated scedosporiosis have also been reported in immunocompetent subjects. It often causes subcutaneous mycetoma, despite its preferential tropism to CNS. The authors describe a fatal case of a S. apiospermum brain abscess in a 58-year-old female. She was affected by chronic liver disease and idiopathic pulmonary fibrosis and had been treated with corticosteroid therapy for a long time. She recovered in a neurosurgery unit, wherein TC scan and cerebral MRI revealed an expansive left temporo-parietal process with vasogenic oedema. A stereotactic puncture of the lesion was carried out, and pus of brain abscess was evacuated. Empirical antifungal therapy was initiated with liposomal amphotericine B based on the clinical suspicion of Zygomycetes infection; after 3 days, posaconazole was added. The correct aetiological diagnosis arrived too late and the patient was treated with no specific therapy. This fatal case confirms the necessity of having a fast and correct aetiological diagnosis to improve the patient's outcome. PMID:21678124

  6. Subareolar abscess

    MedlinePlus

    ... gland. The areolar gland is located in the breast under or below the areola (colored area around the nipple). ... an ultrasound or other imaging test of the breast is recommended. A blood count and a culture of the abscess, if drained, may be ordered.

  7. [Pituitary abscess].

    PubMed

    Díaz-Aramendi, A; Garibi, J; Zorrilla, J; Aurrechoechea, J; Claro, T

    1993-01-01

    A pituitary abscess case clinically evolving as an adenoma is presented. The diagnosis was established at the time the surgical procedure was performed. Previous studies and postoperative investigation proved the absence of features accounting for side infection. Moreover, anatomopathological studies also dismissed the existence of any type of tumoral traces. However, due to a lack of experience, the pre-operative magnetic resonance imaging was interpreted as pertaining to pituitary adenoma on the basis of its greater frequency. PMID:8247215

  8. Epidural abscess

    MedlinePlus

    ... to reduce pressure on the spinal cord or brain, if there is weakness or damage to the nerves. ... Early diagnosis and treatment greatly improves the chance of a ... are reduced. Permanent nervous system damage or death may occur.

  9. Abscess scan - radioactive

    MedlinePlus

    Radioactive abscess scan; Abscess scan; Indium Scan; Indium-labelled white blood cell scan ... the white blood cells are tagged with a radioactive substance called indium. The cells are then injected ...

  10. Abscess - abdomen or pelvis

    MedlinePlus

    ... 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 ...

  11. Resolution of innumerable cerebral Nocardia paucivorans abscesses after medical management.

    PubMed

    Delavari, Nader; Than, Khoi D; Chen, Kevin S; McKeever, Paul E; Wang, Anthony C; Pandey, Aditya S

    2016-05-01

    Nocardia species are an infrequent cause of brain abscesses. We report a 50-year-old man with Nocardia paucivorans cerebral abscesses. Brain MRI revealed innumerable small ring-enhancing lesions. The patient initially responded to treatment with antibiotics and steroids, but experienced worsening after discontinuation of steroids. Brain biopsy performed to exclude central nervous system lymphoma produced nodular tissue with branching filaments on silver stain. Steroids were re-initiated and tapered slowly. The patient completed 1year of antibiotic therapy, after which he had no neurological symptoms and complete resolution of all brain abscesses on MRI. PMID:26765763

  12. Tuberculous retropharyngeal abscess revisited

    PubMed Central

    Menon, Eva; Baruah, Paramita

    2014-01-01

    Retropharyngeal tubercular abscess is an uncommon cause of neck pain and dysphagia in the developed world. In this report, we describe an insidiously presenting retropharyngeal abscess treated successfully with intraoral aspiration and antitubercular chemotherapy. A 33-year-old female patient presented with neck pain and dysphagia. MRI revealed a large retropharyngeal abscess that was aspirated intraorally under local anaesthetic. Diagnosis of tuberculosis (TB) was confirmed by positive culture. The patient improved significantly following the initiation of antitubercular therapy. Retropharyngeal abscess is a recognised presentation of TB. The treatment is mainly medical with combination of specific antitubercular antibiotics, and aspiration may be sufficient for abscess drainage. PMID:24632900

  13. A Case of Brain Abscess Caused by Propionibacterium acnes 13 Months after Neurosurgery and Confirmed by 16S rRNA Gene Sequencing

    PubMed Central

    Chung, Soie; Kim, Jun Sik; Seo, Sang Won; Ra, Eun Kyung; Joo, Sei-Ick; Kim, So Yeon; Park, Sung Sup

    2011-01-01

    Propionibacterium acnes is a gram-positive anaerobic bacillus and a normal inhabitant of the skin. Although it is often considered a contaminant of blood cultures, it can occasionally cause serious infections, including postoperative central nervous system infections. Here, we report the case of a 70-yr-old man who developed a large cerebral abscess caused by P. acnes 13 months after neurosurgery. Immediate gram staining of the pus from his brain revealed the presence of gram-positive coccobacilli. However, colony growth was observed only after 5 days of culture. Therefore, we performed 16S rRNA gene sequencing of the pus specimen. The isolate was identified as P. acnes. The colonies developed 9 days after the initial culture. The API Rapid ID 32A test (bioMérieux, France) was performed using a colony, but an unacceptable profile was obtained. Then, the pus was transferred into the enrichment broths of the BACTEC FX (Becton Dickinson, USA) and BacT/Alert 3D (bioMérieux, Organon Teknika, USA) systems, but only the BACTEC FX system could detect growth after 5 days. We performed 16S rRNA gene sequencing and API Rapid 32A profiling with a colony recovered from Brucella agar, which was inoculated with the microbial growth in the enrichment broth from the BACTEC FX system. The organism was identified as P. acnes by both methods. This case suggests that 16S rRNA gene sequencing may be a useful alternative for identifying slowly growing P. acnes from specimens that do not show growth after 5 days of culture. PMID:21474989

  14. Spinal epidural abscess.

    PubMed

    Miftode, E; Luca, V; Mihalache, D; Leca, D; Stefanidis, E; Anuţa, C; Sabadis, L

    2001-01-01

    In a retrospective study, 68 patients with Spinal Epidural Abscess (SEA) were reviewed. Of these, 66% had different predisposing factors such as staphylococcal skin infections, surgical procedures, rachicentesis, trauma, spondilodiscitis. Abscess had a lumbar region location in 53% of cases. Staphylococcus aureus was the most frequent etiological agent (81%). The overall rate of mortality in SEA patients was 13.2%. PMID:12092238

  15. Multiple listerial liver abscesses.

    PubMed Central

    Jenkins, D; Richards, J E; Rees, Y; Wicks, A C

    1987-01-01

    Hepatic involvement in listeriosis is uncommon in adults. Cases previously reported include three presenting as acute hepatitis and three of listerial liver abscesses found at necropsy. We report a case of multiple listerial liver abscesses. We believe this to be the first time this diagnosis has been made in a living patient. PMID:3428693

  16. Tuberculous psoas abscess.

    PubMed

    Harrigan, R A; Kauffman, F H; Love, M B

    1995-01-01

    Although its historical significance is well established, Mycobacterium tuberculosis today is considered an extremely rare cause of psoas abscess. Nontuberculous bacterial infection, most commonly secondary to an intraabdominal process but at times appearing without an identifiable source, is responsible for the vast majority of psoas abscesses. The recent resurgence of tuberculosis may portend another change in the etiologic trend of psoas abscess. It is essential that the emergency physician not only recognize the potentially subtle presentation of psoas abscess, but also include tuberculosis in the differential diagnosis of infectious causes of this entity. A case of tuberculous psoas abscess in an HIV-negative man is presented. A review of the anatomy, pathophysiology, clinical presentation, epidemiology, and treatment follows, highlighting the similarities and differences between tuberculous and nontuberculous psoas infection. PMID:7594368

  17. Mumps Presenting as a Parotid Abscess.

    PubMed

    Kim, Jong Seung; Oh, Jong Seok; Kwon, Sam Hyun; Kim, Min Su; Yoon, Yong Joo

    2016-05-01

    Parotid abscess is an uncommon condition in infants. It is frequently associated with prematurity, prolonged gavage feeding, and dehydration. Mumps is a viral disease caused by paramyxovirus. It frequently involves the parotid gland and is only rarely found in the pancreas, testis, or brain. The authors describe a rare case of a 10-month-old infant with mumps who developed the classical manifestations of unilateral acute parotitis progressing to formation of a parotid abscess that responded to 2 rounds of surgical drainage and antibiotic therapy. PMID:27159869

  18. [Management of Lung Abscess].

    PubMed

    Marra, A; Hillejan, L; Ukena, D

    2015-10-01

    A lung abscess is an infectious pulmonary disease characterised by the presence of a pus-filled cavity within the lung parenchyma. The content of an abscess often drains into the airways spontaneously, leading to an air-fluid level visible on chest X-rays and CT scans. Primary lung abscesses occur in patients who are prone to aspiration or in otherwise healthy individuals; secondary lung abscesses typically develop in association with a stenosing lung neoplasm or a systemic disease that compromises immune defences, such as AIDS, or after organ transplantation. The organisms found in abscesses caused by aspiration pneumonia reflect the resident flora of the oropharynx. The most commonly isolated organisms are anaerobic bacteria (Prevotella, Bacteroides, Fusobacterium, Peptostreptococcus) or streptococci; in alcoholics with poor oral hygiene, the spectrum of pathogens includes Staphylococcus aureus, Streptococcus pyogenes and Actinomyces. Chest radiography and computed tomography (CT) are mandatory procedures in the diagnostic algorithm. Standard treatment for a lung abscess consists of systemic antibiotic therapy, which is based on the anticipated or proven bacterial spectrum of the abscess. In most cases, primary abscesses are successfully treated by calculated empiric antibiotic therapy, with an estimated lethality rate of less than 10 %. Secondary abscesses, despite targeted antimicrobial therapy, are associated with a poor prognosis, which depends on the patient's general condition and underlying disease; lethality is as high as 75 %. Negative prognostic factors are old age, severe comorbidities, immunosuppression, bronchial obstruction, and neoplasms. Surgical intervention due to failure of conservative treatment is required in only 10 % of patients, with a success rate of up to 90 % and postoperative mortality rates ranging between 0 and 33 %. Treatment success after endoscopic or percutaneous drainage is achieved in 73 to 100 % of cases, with an acceptable mortality rate (0-9 %). PMID:26351764

  19. Nonsurgical drainage of splenic abscess

    SciTech Connect

    Berkman, W.A.; Harris, S.A. Jr.; Bernardino, M.E.

    1983-08-01

    The mortality associated with intraabdominal abscess remains high despite modern surgical methods and antibiotics. Draingae of abscesses of the abdomen, retroperitoneum, pelvis, pancreatic pseudocyst, mediastinum, and lung may be treated effectively by percutaneous catheter placement. In several reports of percutaneous abdominal abscess drainage, only three cases of splenic abscess drainage have been reported. The authors have recently drained two splenic abscesses with the aid of computed tomography (CT) and emphasize several advantages of the percutaneous guided approach.

  20. Parapharyngeal abscess is frequently associated with concomitant peritonsillar abscess.

    PubMed

    Klug, Tejs Ehlers; Fischer, Anne Sophie Lind; Antonsen, Christine; Rusan, Maria; Eskildsen, Helle; Ovesen, Therese

    2014-06-01

    To characterize patients with parapharyngeal abscess admitted to a Danish tertiary care centre and evaluate our management. This is a retrospective chart review. All records of patients with parapharyngeal abscess admitted to the Ear-Nose-Throat Department at Aarhus University Hospital, Denmark, from January 2001 through December 2011 were reviewed. In total, 63 patients (41 males), aged 4-89 years (median, 45 years) were included in the study. The mean annual incidence of parapharyngeal abscess was 0.9 cases/100,000 population. Thirty-three (52%) patients had concomitant peritonsillar abscess. In two patients the parapharyngeal abscess was accompanied by necrotizing fasciitis. The most frequent surgical approach used was intrapharyngeal incision in combination with tonsillectomy. The most commonly used antibiotic regimen was benzylpenicillin plus metronidazole. Seven (13%) patients returned to the operating theatre due to post-tonsillectomy haemorrhage or insufficient abscess drainage. Tonsillectomy and internal incision of the abscess in combination with a narrow-spectrum intravenous penicillin and metronidazole is a safe and efficient approach for managing parapharyngeal abscesses. This approach, however, carries a relatively high complication rate, requiring close surveillance in the early post-operative period. This is especially true for parapharyngeal abscess patients without peritonsillar abscess. In our series, these patients were more ill, more likely to experience complications, require intensive care, intubation, and tracheotomy, than parapharyngeal abscess patients with concurrent peritonsillar abscess. The frequent co-existence of parapharyngeal abscess and peritonsillar abscess favours careful consideration of addition of tonsillectomy to intrapharyngeal incision. PMID:23982668

  1. Idiopathic thyroid abscess

    PubMed Central

    Cawich, Shamir O.; Hassranah, Dale; Naraynsingh, Vijay

    2014-01-01

    INTRODUCTION Thyroid abscesses are uncommon because the gland is relatively resistant to developing infection due to its rich blood supply, well-developed capsule and high iodine content. However, clinicians must be aware of this differential to make an early diagnosis. PRESENTATION OF CASE We present the case of a patient who required urgent operative resection as definitive treatment for a thyroid abscess secondary to infection with Staphylococcus aureus. DISCUSSION Although this is rare, a thyroid abscess left untreated can lead to serious morbidity. Therefore, clinicians must be aware of the presenting features and therapeutic options. CONCLUSION Thyroid abscess is an uncommon diagnosis but can lead to significant morbidity. Therefore clinicians must be aware of the diagnosis in order to institute early aggressive management. PMID:24981167

  2. Pyogenic liver abscess

    MedlinePlus

    ... of liver abscesses, including: Abdominal infection, such as appendicitis , diverticulitis , or a perforated bowel Infection in the ... often, surgery is required. You will also receive antibiotics for about 4 - 6 weeks. Sometimes, antibiotics alone ...

  3. Spinal cord abscess

    MedlinePlus

    ... irritation (inflammation) and the collection of infected material (pus) in or around the spinal cord. ... occurs as a complication of an epidural abscess . Pus forms as a collection of: Destroyed tissue cells ...

  4. Neonatal iliopsoas abscess.

    PubMed

    Horiuchi, Atsushi; Kameoka, Kazuhiro; Kuwabara, Jun; Watanabe, Yuji; Kawakami, Sanae; Tauchi, Hisamichi; Ishii, Eiichi

    2012-10-01

    Iliopsoas abscess (IPA) is rare in children, particularly in neonates. A male neonate was born at 38 weeks of gestation with a weight of 2915 g. On day 22 after birth, his family noticed that his right thigh was swollen. Abdominal computed tomography showed a mass extending to the right iliopsoas from the right thigh with thick septa. Puncture to the right groin yielded purulent fluid, and so a diagnosis of abscess was made. The puncture was followed by surgical drainage through a small inguinal incision, and the abscess cavity was irrigated thoroughly using normal saline. Culture of abscess fluid was positive for Streptococcus pneumoniae, so intravenous ABPC infusion was continued. The postoperative magnetic resonance imaging indicate that the IPA was derived from arthritis of the hip, and the patients received Riemenbügel for the incomplete hip dislocation. He is doing well at 2 years of age. PMID:23005905

  5. [Acute periproctal abscesses].

    PubMed

    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. PMID:24881481

  6. [Pulmonary abscesses and bronchiectasis].

    PubMed

    Ris, H B; Stocker, J M; Im Hof, V

    1999-04-10

    Both primary and secondary pulmonary abscesses are increasingly observed in thoracic surgery units. Primary pulmonary abscesses are related to necrotising pneumonia or aspiration due to alcoholism, drug abuse, dysphagia or gastrointestinal reflux disease. Secondary poststenotic abscesses are related to bronchial obstruction (endobronchial tumour or foreign body aspiration) or to superinfection of pulmonary neoplasia or infarction pneumonia. Bronchoscopy is mandatory if a pulmonary abscess is suspected, to exclude endobronchial obstruction and obtain bacteriological examination by bronchial lavage or transbronchial fine needle aspiration. Transthoracic fine needle aspiration may be helpful for bacteriological examination, since germs found in sputum do not necessarily correlate with those found in the abscess. Pulmonary abscesses are primarily treated by administration of appropriate antibiotics with a remission rate of 80%. In the presence of complications of the abscess or if conservative management fails, percutaneous transthoracic drainage or surgical resection may be indicated. Bronchiectasis is also increasingly seen, especially in refugees and immigrants. The disease is characterised by chronic dilatation of bronchi with paroxysmal cough, mucopurulent secretion and recurrent pulmonary infections. Bronchiectasis is most commonly caused by recurrent bronchial infections during childhood or behind bronchial obstruction. Congenital bronchiectasis is very rare. Viral and bacterial pulmonary infections during childhood are by far the most common causes of bronchiectasis, leading to destruction of the mucociliary apparatus and the cartilage of the segmental bronchi. Bronchiectasis should be treated by an appropriate antibiotic regimen. Resection should only be considered in situations where a conservative regimen fails. Segmentectomy of all involved segments is the surgical treatment of choice in situations with well-localised bronchiectasis and results in long-lasting remission in over 80% of those patients. Patients with bilateral bronchiectasis may be considered for bilateral surgical resection if diffuse and congenital disease has been ruled out. PMID:10321007

  7. [Complicated abscesses of the lungs].

    PubMed

    Gukasian, E A; Muromskiĭ, Iu A

    1985-07-01

    The work is based upon the treatment of 445 patients with complicated abscesses of the lungs for the period from 1963 to 1984. 158 operations were performed in 149 patients. General lethality in patients with complicated abscesses of the lungs was 11%. The operative treatment is thought to be absolutely indicated in patients with abscesses of the lungs complicated by hemorrhage and in patients with gangrenous abscesses of the lungs. PMID:4060481

  8. Abscess formation within a cerebellar metastasis: Case report and literature review

    PubMed Central

    Goto, Yukihiro; Ebisu, Toshihiko; Mineura, Katsuyoshi

    2015-01-01

    Introduction The managements of brain abscesses and brain tumors including brain metastases differ greatly, especially in terms of surgical procedures. Therefore, differentiating between the two is essential for assuring optimal treatment. However, on rare occasion, these two lesions coexist. Only five cases with both a brain tumor and an abscess have thus, far been reported. We experienced a patient with a brain abscess within a cerebellar metastasis. Case presentation A middle-aged man receiving treatment for bile duct cancer presented with headache and nausea. Computed tomography (CT) and magnetic resonance (MR) imaging revealed two lesions, one in each cerebellar hemisphere. Although these lesions appeared to be brain metastases, the right lesion showed high intensity on diffusion-weighted images (DWI), and magnetic resonance spectroscopy (MRS) findings suggested an abscess. Surgical puncture of the lesion identified it as a brain abscess histologically, and we thus, administered antibiotics. However, since the lesion grew, we performed a second surgery for removal, which histopathologically the lesion to be a well-differentiated adenocarcinoma. The final diagnosis was an abscess within a cerebellar metastasis. Discussion/conclusion Modern diagnostic tools such as DWI and MRS are reportedly reliable for differentiating brain tumors from brain abscesses, though they are not specific in cases with both lesions. The present case highlights the importance of considering coexisting diseases prior to surgery when we encounter a lesion which has the imaging characteristics of both a tumor and an abscess. The patient may have a better outcome if, preoperatively, surgeons take into consideration the possibility of the coexistence of a brain tumor and a brain abscess. PMID:25799962

  9. Neonatal orbital abscess

    PubMed Central

    Gogri, Pratik Y.; Misra, Somen L.; Misra, Neeta S.; Gidwani, Hitesh V.; Bhandari, Akshay J.

    2015-01-01

    Orbital abscess generally occurs in older children but it can rarely affect infants and neonates too. We report a case of community acquired methicillin resistant staphylococcus aureus (CA-MRSA) neonatal orbital abscess in a 12-day-old term female neonate with no significant past medical history or risk factor for developing the infection. The case highlights the importance of consideration of CA-MRSA as a causative agent of neonatal orbital cellulitis even in a neonate without any obvious predisposing condition. Prompt initiation of appropriate medical therapy against MRSA and surgical drainage of the abscess prevents life threatening complications of orbital cellulitis which more often tend to be fatal in neonates. PMID:26622145

  10. Hepatic abscesses after adhesiolysis

    PubMed Central

    Antonsen, J.; Balachandran, R.; Helgstrand, F.

    2015-01-01

    Introduction Hematogenous spread of bacteria from the bowel due to bacterial translocation has been postulated in animal and trauma studies. This case presents a patient with possible hematogenous bacterial spreading after acute laparotomy. Case presentation A 57-year old woman was admitted with abdominal pain. A computed tomography showed mechanical small bowel obstruction. A laparotomy was performed showing no contamination, and no bowel resection was performed. The patient was not given any antibiotics during this time. The patient was re-admitted 24 h after discharge with fever, elevated white count and abdominal pain. A computed tomography showed newly developed intrahepatic abscesses. These were treated with antibiotics, and the patient was discharged with follow-up ultrasound showing diminished abscesses. Discussion This case discusses the possible pathophysiology behind the development of intrahepatic abscesses after small bowel obstruction. Conclusion Febrilia and pain in upper right quadrant of the abdomen days after a simple operation for bowel obstruction could be caused by translocation of intestinal bacteria and subsequent formation of hepatic abscesses. PMID:26410805

  11. First Case of Cerebral Abscess Due to a Novel Nocardia Species in an Immunocompromised Patient

    PubMed Central

    Flateau, C.; Jurado, V.; Lemaître, N.; Loïez, C.; Wallet, F.; Saiz-Jimenez, C.; Decoene, C.; Bergeron, E.; Boiron, P.; Faure, K.; Guery, B.

    2013-01-01

    We report the first case of cerebral abscess due to a novel species of Nocardia in a heart transplant patient and describe the antimicrobial susceptibility of this isolate. As our patient was intolerant to trimethoprim-sulfamethoxazole, we also discuss alternative therapeutic options in brain abscess due to Nocardia sp. PMID:23224088

  12. Tubercular thyroid abscess.

    PubMed

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

    2013-01-01

    We encountered a patient who presented with neck swelling, difficulty in swallowing, voice change along with systemic features such as evening rise of temperature, chronic cough and weight loss. Ultrasonography of the thyroid gland revealed two cystic swellings. An ultrasound guided fine needle aspiration cytology was suggestive of tubercular abscess. The patient responded well to antigravity aspiration of the swellings and antitubercular treatment. PMID:23814203

  13. Lacrimal duct cyst abscess.

    PubMed

    Dharmasena, Aruna; Sobajo, Cassandra; Irion, Luciane; Ataullah, Sajid

    2014-12-01

    Cystic dilatation within the lacrimal gland is thought to be related to chronic inflammation and scarring of the lacrimal gland ductules. We review the literature and discuss a case and of lacrimal duct cyst suppuration presenting with visual loss, external ophthalmoplegia, proptosis and ptosis. To our knowledge, only one other report of a lacrimal ductal cyst abscess has been reported in the literature so far. PMID:25208223

  14. Lung abscess and empyema.

    PubMed

    Neild, J E; Eykyn, S J; Phillips, I

    1985-12-01

    Forty-eight patients presenting with lung abscess or empyema were studied between 1976 and 1984. The clinical features, diagnostic techniques and management are discussed. Aerobes were cultured from specimens obtained in 37.5 per cent of cases, both aerobes and anaerobes in 54.2 per cent and anaerobes alone in only 8.3 per cent. Bacteroides fragilis was not isolated. Forty-two per cent of patients had previously received antibiotics, but fully sensitive organisms were grown from 17 of 20 specimens from this group. Forty-five per cent of aerobes and 17.8 per cent of anaerobes were resistant to penicillin. There were no specific clinical features which distinguished the patients with a lung abscess from those with an empyema, nor between those with an underlying abnormality and those in whom the infection arose in a previously normal lung. Lung abscesses should be treated medically with intensive physiotherapy and appropriate antibiotics; penicillin can no longer be considered the antibiotic of choice. If the cavity fails to drain satisfactorily, further investigations should be undertaken to exclude a tumour or other underlying abnormality. PMID:4095257

  15. Therapy of Liver Abscesses

    PubMed Central

    Lbbert, Christoph; Wiegand, Johannes; Karlas, Thomas

    2014-01-01

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

  16. [Cerebral trunk abscess due to Neisseria meningitidis in a 28-year-old immunocompetent patient].

    PubMed

    Faisant, C; Cochin, J P; Rapoport, N; Evreux, F; Vaschalde, Y

    2012-03-01

    Meningococcal disease can manifest in very different clinical situations. Meningococcal meningitis and fulminant meningococcemia (or purpura fulminans) are the most common forms of these infections, but many other manifestations can be seen including septic arthritis, pericarditis, pleurisy and conjunctivitis. Brain abscesses have also been described; they are a rare complication of meningococcal disease. We report the case of a 28-year-old immunocompetent patient who developed meningococcal infection associated with brain abscesses and oligo-arthritis. PMID:22284670

  17. Chemical epidural abscess: case report

    PubMed Central

    Vijayan, N.; Dreyfus, P. M.

    1971-01-01

    Spinal epidural abscess accompanies blood-borne infection, vertebral osteomyelitis, or an overlying cutaneous source of infection. This report documents the development of non-infective epidural abscess where the inflammatory response was induced by the highly irritant contents (keratin and cholesterol) of an underlying epidermoid. This was associated with aseptic meningitis. Images PMID:5571318

  18. Intracranial abscess in Ectopia Cordis.

    PubMed

    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. PMID:25153988

  19. Dental abscess: A microbiological review

    PubMed Central

    Shweta; Prakash, S Krishna

    2013-01-01

    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. PMID:24348613

  20. [Lung abscess: changes in treatment?].

    PubMed

    Clottu, E; Nicod, L P

    2015-11-18

    Lung abscess occurs in very pleomorphic according to germs initially involved. The mechanism commonly found is an aspiration of the oropharyngeal flora in patients with disorders of consciousness or swallowing. The infection is polymicrobial, with presence of anaerobic germs in 2/3 of the cases. The support consists of a prolonged antibiotic treatment, as well as anaerobic until resolution or stability of the radiological image. In case of prolonged toxic state, drainage of the abscess is to be discussed especially if there is no airways drainage. Surgical sanctions is rarely needed regardless of the size of the abscess, unless underlying carcinoma is present. PMID:26742239

  1. Liver abscesses in feedlot cattle.

    PubMed

    Nagaraja, T G; Lechtenberg, Kelly F

    2007-07-01

    Liver abscesses in feedlot cattle result from aggressive grain-feeding programs and are influenced by a number of dietary and management factors. They have a major economic impact on the feedlot industry because of liver condemnation and reduced animal performance and carcass yield. Ruminal lesions resulting from acidosis usually are accepted as the predisposing factors. Generally, control of liver abscesses in feedlot cattle has depended on the use of tylosin, which reduces abscess incidence by 40% to 70%. However, new methods and products for liver abscess control are needed. Corn milling by-products that are less fermentable may aide in the quest for cattle production techniques that lead to lower usage of antimicrobials. A vaccine is also commercially available. PMID:17606156

  2. Percutaneous drainage of lung abscess.

    PubMed

    Shim, C; Santos, G H; Zelefsky, M

    1990-01-01

    Most lung abscesses are successfully treated with antibiotics. However, occasional patients with lung abscesses that drain poorly, causing persistent fever and toxic symptoms, may require surgical intervention. Lobectomy is the most frequent surgical procedure. Some patients are debilitated and have underlying medical conditions such as heart disease, chronic pulmonary disease, or liver disease that may render surgical intervention risky. Recently there have been reports of percutaneous drainage of lung abscess with good results. We have successfully carried out percutaneous drainage of lung abscess in 4 patients and an infected bulla in 1. All patients had failed to respond to therapy with antibiotics and postural drainage. There was prompt disappearance of the fluid level in the cavity, decline in temperature, and abatement of toxic symptoms with drainage. The cavities closed gradually over the next 6-12 weeks. The patients tolerated the chest tube well and there were no side effects from the tube drainage. Percutaneous tube drainage is the surgical treatment of choice in the medically complicated patient with a poorly draining lung abscess. PMID:2122136

  3. Fusobacterium necrophorum hemolysin in bovine hepatic abscess.

    PubMed

    Kanoe, M

    1990-12-01

    An immunofluorescence study was made on bovine hepatic abscess containing Fusobacterium necrophorum predominantly. The abscess section stained with anti F. necrophorum hemolysin serum demonstrated fluorescence which formed irregular and granular shapes. Actinomyces pyogenes isolates from the abscess were not stained with the serum. These findings suggest that the bacterial hemolysin contributes to the formation of the hepatic abscess during an infection with F. necrophorum. PMID:2082629

  4. Spinal epidural abscess in brucellosis.

    PubMed

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

    2013-01-01

    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. PMID:24072838

  5. Pyogenic liver abscess: uncommon presentation.

    PubMed

    Sotto Mayor, Joana; Robalo, Maria Margarida; Pacheco, Ana Paula; Esperança, Sofia

    2016-01-01

    Pyogenic liver abscess is a rare entity, but it is fatal when untreated. With a peak incidence in the fifth decade of life, its early recognition and intervention are key to successful treatment and better prognosis of patients. In recent years, its approach has been enhanced by the use of percutaneous drainage, improved imaging techniques and a better microbiological characterisation, allowing for a more appropriate use of antibiotics. Clinical manifestations are variable and depend on the size of the abscess, the condition of the patient, associated diseases and possible complications. Among the most common symptoms that stand out are the pain in the upper quadrants of the abdomen, high fever, nausea and vomiting. The authors present the case of a patient who developed an atrial flutter as the initial presentation of a hepatic abscess that imagiologically mimicked a hepatic tumour. PMID:27170608

  6. Relapsing polychondritis with splenic abscess.

    PubMed

    Tudor, Aura; Sârcă, Gabriela; Peţa, D; Cochior, D; Pripişi, L; Valcoreanu, Georgica; Bari, Maria; Bedereag, S

    2003-01-01

    A patient aged 42, diagnosed with polycondritis for approximately 14 years is presented; she has undergone urgent surgery for a splenic abscess in imminent fistulization in the left pleural cavity. Her susceptibility to infections is marked in time by surgical interventions for pultaceous amygdalitis, an abscess of the right submandibular salivary gland, a splenic abscess. To be noted the peculiar connection between the illness and the pregnancy, which differs from the data to be found in reference literature that is the association with a tendency to spontaneous abortion and the sudden installation of an evolutionary acute episode during pregnancy, which was followed by deafness. Based on these facts, immunopathogenic observations on recurrent polycondritis are getting into shape. PMID:15526515

  7. Percutaneous management of multiple liver abscesses

    SciTech Connect

    Greenwood, L.H.; Collins, T.L.; Yrizarry, J.M.

    1982-08-01

    Percutaneous catheter drainage is now an accepted technique in the management of hepatic and other intraabdominal abscesses. Most abscesses accepted by the radiologist for drainage are unilocular with a safe percutaneous approach. This report demonstrates that even multiple hepatic abscesses may be successfully managed by percutaneous drainage. The use of computed tomography (CT) for diagnosis and sonography for safe puncture guidance is discussed.

  8. Caruncular abscess due to actinomycosis.

    PubMed

    Lee, Yeon-Hee; Kim, Woo-Jin; Lee, Sung-Bok

    2013-08-01

    The authors report a caruncular abscess caused by actinomycosis. A 47-year-old woman was admitted with persistent purulent discharge from the caruncle of the left eye for a duration of six months. Excisional drainage was performed, and 'sulfur granules' were observed, consistent with actinomyces infection. Intraoperative lacrimal probing and irrigation were performed to confirm that the abscess and canaliculus were not connected. Oral and topical antibiotics were administered postoperatively; the lesion resolved with no evidence of recurrence, and the symptom improved. PMID:23908576

  9. Caruncular Abscess Due to Actinomycosis

    PubMed Central

    Lee, Yeon-Hee; Kim, Woo-Jin

    2013-01-01

    The authors report a caruncular abscess caused by actinomycosis. A 47-year-old woman was admitted with persistent purulent discharge from the caruncle of the left eye for a duration of six months. Excisional drainage was performed, and 'sulfur granules' were observed, consistent with actinomyces infection. Intraoperative lacrimal probing and irrigation were performed to confirm that the abscess and canaliculus were not connected. Oral and topical antibiotics were administered postoperatively; the lesion resolved with no evidence of recurrence, and the symptom improved. PMID:23908576

  10. Pyogenic psoas abscess: analysis of 27 cases.

    PubMed

    Lin, M F; Lau, Y J; Hu, B S; Shi, Z Y; Lin, Y H

    1999-12-01

    From 1993 to 1998, 29 pyogenic psoas abscesses occurring in 27 patients were seen in Taichung Veterans General Hospital. Their age range was 25 to 85 years. Diabetes mellitus was the leading underlying disease. Fever and pain in the flank area, back and hip were the usual manifestations. The duration of symptoms prior to the diagnosis ranged from 3 days to 6 months. Most abscesses were diagnosed by computed tomography (CT) images and proven by abscess cultures, which were divided into primary and secondary types. Eighteen of 29 abscesses were regarded as primary. Staphylococcus aureus was the most common pathogen in the primary abscesses, followed by Streptococcus agalactiae, Escherichia coli, viridans streptococci, S. epidermidis, and Salmonella spp.. In the secondary abscess category, E. coli was the leading organism in this series, followed by S. aureus, Klebsiella pneumoniae, viridans streptococci and Candida albicans. The associated conditions included epidural abscess, osteomyelitis, septic arthritis, perirenal abscess, pulmonary tuberculosis, empyema, hydronephrosis and trauma history. The initial empiric therapy comprised mostly of cefazolin or oxacillin with or without an aminoglycoside. Thirteen patients underwent percutaneous drainage, while six received surgical debridement, including two with a recurrent abscess. One patient had both drainage and debridement. Others received medical treatment only. Two of the patients with primary abscess died in spite of percutaneous drainage. Therefore, open drainage, besides appropriate antibiotic treatment, is still required to control complex abscesses with sepsis. PMID:10650491

  11. Supra-sellar tubercular abscess

    PubMed Central

    Joshi, Vijay P.; Agrawal, Amit; Mudkanna, Anand; Rudrakshi, S. S.; Kelkar, G. P.

    2016-01-01

    Intracranial tuberculomas are less common lesions; sellar, suprasellar, or parasellar involvement is further rarer with only few case reports in the literature. We describe a case of 44-year-old female, discussing the imaging findings that were managed successfully for tubercular hypothalamic-pituitary abscesses.

  12. Brain

    MedlinePlus

    ... will return after updating. Resources Archived Modules Updates Brain Cerebrum The cerebrum is the part of the ... the outside of the brain and spinal cord. Brain Stem The brain stem is the part of ...

  13. Multicystic Hepatocarcinoma Mimicking Liver Abscess

    PubMed Central

    Falidas, Evangelos; Pazidis, Angelos; Anyfantakis, Georgios; Vlachos, Konstantinos; Goudeli, Christina; Villias, Constantinos

    2013-01-01

    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. PMID:23365779

  14. Idiopathic bilateral male breast abscess

    PubMed Central

    Sinha, Rajan Kumar; Sinha, Mithilesh Kumar; Gaurav, Kumar; Kumar, Amar

    2014-01-01

    A 38-year-old man presented with bilateral breast swelling, along with pain and redness for 7 days. Bilateral axillary nodes were also palpable; which were multiple and discrete. A provisional diagnosis of bilateral breast abscess was made with suspicion of underlying malignancy. Incision and drainage through subareolar incision was performed and the adjoining tissue was excised and sent for histopathological examination. PMID:24614823

  15. Candida parotitis with abscess formation.

    PubMed

    Even-Tov, Ella; Niv, A; Kraus, M; Nash, Michael

    2006-03-01

    This report describes the case of an elderly, diabetic man who developed acute suppurative parotitis with abscess formation. The causative agent of parotid abscess was Candida albicans, which is an unusual cause of salivary gland pathology. The parotid gland is the salivary gland most commonly affected by inflammation. Acute parotitis occurs most often in elderly patients who are debilitated by systemic disease or are in a state of dehydration following major surgical procedures. Despite the high prevalence of oral candida carriage, there have been few previous reports of candida sialoadenitis in the literature. This is due to the toxicity of saliva to fungi under normal conditions. The diagnosis of candidiasis in our patient was made by culturing the purulent discharge from Stensen's duct and by culture of the pus obtained at surgical drainage of the abscess. After incision and drainage, the patient was treated with intravenous and then oral fluconazole for a total of 4 weeks with complete resolution of his condition. This case is interesting in light of recent and ongoing investigations of salivary proteins as potential new antifungal agents. PMID:16618667

  16. Intrahepatic Cholangiocarcinoma Masquerading as Liver Abscess

    PubMed Central

    Shah, Vinit; Arora, Anil; Tyagi, Pankaj; Sharma, Praveen; Bansal, Naresh; Singla, Vikas; Bansal, Rinkesh K.; Gupta, Varun; Kumar, Ashish

    2015-01-01

    Malignancy masquerading as liver abscess, and presenting with fever, is mainly described in patients with colorectal cancers with liver metastasis. Primary liver tumors such as hepatocellular carcinoma or intrahepatic cholangiocarcinoma presenting as non-resolving liver abscess is extremely uncommon and carries a dismal prognosis. We present a rare case of non-resolving liver abscess as a presenting manifestation of intrahepatic cholangiocarcinoma. PMID:25941437

  17. Delayed splenic abscess after laparoscopic sleeve gastrectomy.

    PubMed

    Singh, Yardesh; Cawich, Shamir; Aziz, Imran; Naraynsingh, Vijay

    2015-01-01

    Splenic abscesses complicating sleeve gastrectomies are extremely rare. We report the fourth recorded case of a splenic abscess; in our case it occurred 10 weeks after sleeve gastrectomy in a 44-year-old man. The clinical presentation was vague but included the triad of fever, left upper quadrant tenderness and leucocytosis. The presence of this triad after sleeve gastrectomy should prompt investigation with contrast CT scans to exclude a splenic abscess. PMID:25691579

  18. [Pulmonary abscess treated with postural drainage].

    PubMed

    Prnjavorac, B; Ajanović, E; Binakaj, D; Rozajac, S; Djogić, H; Hasukić, S; Denjalić, A; Skiljo, H

    1996-01-01

    Case record of patients with lung abscess treated by postural drainage is presented in this paper. In young man with multiple explosive injuries lung abscess was formed two months after injury. A postural drainage with parenteral application of antibiotics has been performed. The expectoration was painful. At the seventh day there was no temperature, ESR was described at the tenth day. The general status was becoming better. At the seventeenth day patient was discharged from Hospital. Rig imaging was shown nearly completely resolution of lung abscess. Postural drainage was effective because of favorable localisation of abscess near the large bronchus and basely part of the lung. PMID:9333679

  19. Pilonidal Abscess Associated With Primary Actinomycosis

    PubMed Central

    Abdul Malik, Mohamad Hashir; Keh, Chris Hang Liang

    2015-01-01

    Pilonidal disease in the sacrococcygeal region usually presents as abscesses, recurrent inflammation, cellulitis or fistula tracks. However, few reports on actinomycosis affecting pilonidal sinuses have been published. We report a case of a 25-year-old woman who presented with a pilonidal abscess who underwent surgical drainage and debridement. Pus from the pilonidal abscess was sent for microbiology, which grew actinomyces turicensis associated with prevotella bivia and peptostreptococci. She was treated with oral amoxicillin-clavulanate after surgical drainage for one week and recovered well. Actinomycosis associated with pilonidal abscesses, though uncommon, should be recognized and can be satisfactorily treated with a combination of surgical drainage and antibiotics. PMID:26817020

  20. Cerebellar abscess. A review of 47 cases.

    PubMed Central

    Shaw, M D; Russell, J A

    1975-01-01

    Forty-seven cases of cerebellar abscess have been reviewed, 93% of which were secondary to otogenic disease. There has been little change in the annual incidence during the period of time under review. The overall mortality was 41%, but with successive decades the mortality has increased. Three factors appear to be of importance in determining survival: the patient's ability to control his infection; reduction of the effect of the posterior fossa mass, preferably by complete excision of the abscess under antibiotic cover; and, in the case of otogenic abscess, an adequate radical mastoidectomy with bone removal to the site of attachment of the abscess to the dura mater. PMID:1151412

  1. Congenital Prepubic Sinus Accompanied by Prevesical Abscess

    PubMed Central

    Kobayashi, Hideki; Nomura, Teruhisa; Haneda, Yaburu; Sawada, Norifumi; Araki, Isao; Takeda, Masayuki

    2015-01-01

    Congenital prepubic sinus is an extremely rare anomaly. The etiology is uncertain and the anatomical features often differ from each other. We report a 22-year-old woman with a congenital prepubic sinus accompanied by a prevesical abscess. She was admitted to our hospital with high-grade fever and low abdominal pain. Computed tomography revealed a prevesical abscess. After treatment of the prevesical abscess, we completely excised the congenital prepubic sinus. To our knowledge, this is the first reported case that accompanied by prevesical abscess on a congenital prepubic sinus. Moreover, this case represents the oldest reported age of a patient with a congenital prepubic sinus. PMID:25918630

  2. Pilonidal Abscess Associated With Primary Actinomycosis.

    PubMed

    Oh, Han Boon; Abdul Malik, Mohamad Hashir; Keh, Chris Hang Liang

    2015-12-01

    Pilonidal disease in the sacrococcygeal region usually presents as abscesses, recurrent inflammation, cellulitis or fistula tracks. However, few reports on actinomycosis affecting pilonidal sinuses have been published. We report a case of a 25-year-old woman who presented with a pilonidal abscess who underwent surgical drainage and debridement. Pus from the pilonidal abscess was sent for microbiology, which grew actinomyces turicensis associated with prevotella bivia and peptostreptococci. She was treated with oral amoxicillin-clavulanate after surgical drainage for one week and recovered well. Actinomycosis associated with pilonidal abscesses, though uncommon, should be recognized and can be satisfactorily treated with a combination of surgical drainage and antibiotics. PMID:26817020

  3. Giant retropharyngeal abscess secondary to tubercular spondylitis.

    PubMed

    Garg, Ajay; Wadhera, Raman; Gulati, S P; Kishore, Deep; Singh, Jagjit

    2009-10-01

    Chronic retropharyngeal abscess secondary to tubercular spondilitis is a rare phenomenon. Anatomical location of this abscess makes it a life threatening condition requiring prompt diagnosis and treatment thus preventing morbidity and mortality. Authors are documenting a case of tubercular spondylitis of cervical region in a 12-year old male child with huge retropharyngeal abscess extending to superior mediastinum. Clinically, patient had respiratory distress but no neurological deficit. USG (Ultrasonography) guided aspirate of abscess sent for microscopy and culture showed acid fast bacilli. Multiple USG guided aspirations under antibiotic and antitubercular cover (Category I) were done. Patient is doing well at three month follow-up. PMID:20469736

  4. Septic arthritis: a unique complication of nasal septal abscess.

    PubMed

    Olsen, Steven M; Koch, Cody A; Ekbom, Dale C

    2015-03-01

    Nasal septal abscesses (NSAs) occur between the mucoperichondrium and the nasal septum. They most often arise when an untreated septal hematoma becomes infected. The most commonly reported sequela is a loss of septal cartilage support, which can result in a nasal deformity. Other sequelae include potentially life-threatening conditions such as meningitis, cavernous sinus thrombosis, brain abscess, and subarachnoid empyema. We report the case of a 17-year-old boy who developed an NSA after he had been struck in the face with a basketball. He presented to his primary care physician 5 days after the injury and again the next day, but his condition was not correctly diagnosed. Finally, 7 days after his injury, he presented to an emergency department with more serious symptoms, and he was correctly diagnosed with NSA. He was admitted to the intensive care unit, and he remained hospitalized for 6 days. Among the abscess sequelae he experienced was septic arthritis, which has heretofore not been reported as a complication of NSA. He responded well to appropriate treatment, although he lost a considerable amount of septal cartilage. He was discharged home on intravenous antibiotic therapy, and his condition improved. Reconstruction of the nasal septum will likely need to be pursued in the future. PMID:25738728

  5. Minimally invasive image-guided keyhole aspiration of cerebral abscesses

    PubMed Central

    Meng, Xiang-Hui; Feng, Shi-Yu; Chen, Xiao-Lei; Li, Chong; Zhang, Jiashu; Zhou, Tao; Jiang, Jinli; Wang, Fuyu; Ma, Xiaodong; Bu, Bo; Yu, Xin-Guang

    2015-01-01

    Despite the low incidence of brain abscesses in Western nations (1-2%), the incidence in developing countries is as high as 8%. We evaluate a minimally invasive image-guided keyhole aspiration of cerebral abscesses and compare it with a series of cases treated with surgical excision. 23 patients (20 male and 3 female, aged 7-67 years) underwent image-guided burr hole aspiration of single or multiple cerebral abscesses. Patient characteristics, perioperative, and postoperative data were analyzed and compared with a second group of 22 patients (14 male and 8 female, aged 12-72) treated for cerebral abscesses with open surgical excision. In all cases, the surgical procedure was performed successfully without complication. 8 of the 23 aspiration cases were performed with the aid of iMRI. A comparison of patient demographics, duration of hospital stay, duration of antibiotic therapy, postoperative neurological recovery time, intraoperative blood loss, operative duration, length of incision, postoperative fever, repeat surgery, and mortality was performed between the aspiration and excision groups. Intraoperative blood loss, operative duration, length of incision, and postoperative fever were all significantly reduced in the aspiration group. Though, duration of hospital stay and antibiotic therapy and postoperative neurological recovery time were all increased in the aspiration group, and statistical significance was observed in all except the duration of hospital stay. This technique is a feasible and comparable minimally invasive alternative to open surgical excision and may provide reduced intraoperative blood loss, shortened operative duration, improved cosmetic outcomes, and a lessened incidence of postoperative fever. PMID:25784984

  6. Unusual cervical spine epidural abscess.

    PubMed

    Liou, Jr-Han; Su, Yu-Jang

    2015-10-01

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

  7. Pott's Spine with Bilateral Psoas Abscesses

    PubMed Central

    Masavkar, Sanjeevani; Shanbag, Preeti; Inamdar, Prithi

    2012-01-01

    A high degree of suspicion and appropriate imaging studies are required for the early diagnosis of Pott's spine. We describe a 4-year-old boy with Pott's disease of the lumbar spine with bilateral psoas abscesses. The child responded to conservative treatment with antituberculous treatment and ultrasonographically guided percutaneous drainage of the abscesses. PMID:23259114

  8. Microbiology and Treatment of Acute Apical Abscesses

    PubMed Central

    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

  9. Severe pelvic abscess formation following caesarean section.

    PubMed

    Muin, Dana A; Takes, Martin Thanh-Long; Hösli, Irene; Lapaire, Olav

    2015-01-01

    We report a case of a 24-year-old woman with severe pelvic abscess formation 2 weeks after secondary caesarean section. The isolated pathogens were a mixture of Gardnerella vaginalis, Mycoplasma hominis and Ureaplasma urealyticum. After initial resistance to systemic antibiotic treatment, she underwent radiologically-guided drainage of the abscesses, whereon she had a continuous recovery. PMID:25911355

  10. Medical treatment of multiple streptococcal liver abscesses

    SciTech Connect

    Matlow, A.; Vellend, H.

    1983-04-01

    We describe four cases of multiple, cryptogenic, and streptococcal liver abscesses which were cured with antibiotic therapy. Two of the patients were referred for medical management as a last resort after open surgical drainage failed to eradicate the suppurative process. The other two patients were treated from the time of diagnosis with antimicrobial agents alone. Blood cultures or needle aspirates of the abscesses yielded a pure growth of streptococci in all instances. All isolates were susceptible to penicillin G. Cryptogenic streptococcal abscesses may represent a subset of multiple hepatic abscesses particularly amenable to successful medical therapy consisting of a minimum of 6 weeks parenteral antibiotic therapy followed by a period of oral antibiotics until clinical, biochemical, and radiological resolution of the abscesses has occurred.

  11. Nerve abscess in primary neuritic leprosy.

    PubMed

    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. PMID:24171239

  12. An unnoticed origin of fever: periapical tooth abscess. Three case reports and literature review.

    PubMed

    Arslan, Ferhat; Karagöz, Ergenekon; Arslan, Birsen Yigit; Mert, Ali

    2016-03-01

    Dental infections may lead to severe local or systemic infections such as endocarditis, brain abscesses and mediastinitis. Fever may be the only symptom. We aim to highlight dental/odontogenic abscesses as the occult source of unexplained fever by reporting on three cases and reviewing the relevant literature. Early dental evaluation and referral of patients with persistent fever (even without any oral symptoms) to a dentist plays a critical role in preventing unnecessary, time-consuming and high-cost further diagnostic tests and invasive procedures. A simple panoramic dental radiography may suffice to establish the diagnosis. PMID:27031901

  13. Bilateral Psoas Muscle Abscess Associated with Emphysematous Cystitis

    PubMed Central

    Choi, Jae-Ki; Kwon, Jae-Cheol

    2015-01-01

    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. PMID:25755669

  14. Liver abscesses in feedlot cattle: a review.

    PubMed

    Nagaraja, T G; Chengappa, M M

    1998-01-01

    Liver abscesses in slaughtered beef cattle result from aggressive grain-feeding programs. The incidence, averaging from 12 to 32% in most feedlots, is influenced by a number of dietary and management factors. Liver abscesses represent a major economic liability to producers, packers, and ultimately consumers. Besides liver condemnation, economic impacts include reduced feed intake, reduced weight gain, decreased feed efficiency, and decreased carcass yield. Fusobacterium necrophorum, a member of the ruminal anaerobic bacterial flora, is the primary etiologic agent. Actinomyces pyogenes is the second most frequently isolated pathogen. Ruminal lesions resulting from acidosis generally are accepted as the predisposing factors for liver abscesses. F. necrophorum possesses or produces a number of virulence factors that participate in the penetration and colonization of the ruminal epithelium and subsequent entry and establishment of infection in the liver. However, only a few virulence factors have been characterized well. Control of liver abscesses in feedlot cattle generally has depended on the use of antimicrobial compounds. Five antibiotics (i.e., bacitracin methylene disalicylate, chlortetracycline, oxytetracycline, tylosin, and virginiamycin) are approved for prevention of liver abscesses in feedlot cattle. Tylosin is the most effective and the most commonly used feed additive. Tylosin feeding reduces abscess incidence by 40 to 70%. The mode of action of antibiotics in preventing liver abscesses is believed to be via inhibition of ruminal F. necrophorum. Protective immunity against F. necrophorum induced by a variety of antigenic components has ranged from ineffectual to significant protection. PMID:9464910

  15. Lemierre’s disease: a case with bilateral iliopsoas abscesses and a literature review

    PubMed Central

    2014-01-01

    Lemierre’s disease is characterized by sepsis, often with an oropharyngeal source, secondary septic emboli and internal jugular vein thrombosis (Lancet 1:701–3, 1936. Clin Microbiol Rev 20(4):622–59, 2007). Septic emboli affecting many bodily sites have been reported, including the lungs, joints, bones, and brain. The case report describes an unusual case of Lemierre’s disease in a 64 year old gentleman causing profound sepsis, acute kidney injury, bilateral iliopsoas abscesses and a right hand abscess. To our knowledge, this is the first reported case of Lemierre’s disease in the context of bilateral psoas abscesses, and highlights the ambiguity surrounding the definition of Lemierre’s disease. The clinical literature review highlights the difficulty in definitively diagnosing the condition and offers some suggestions for recognising and refining the diagnostic criterion of Lemierre’s. PMID:24904685

  16. Giant intradiploic calvarial abscess of posterior fossa behaving progressive mass lesion.

    PubMed

    Onal, Mehmet Bulent; Civelek, Erdinc; Kircelli, Atilla; Yakupoglu, Hakan; Arslan, Harun; Aygun, Serhat

    2012-10-01

    A unique case of a large intradiploic abscess involving posterior fossa osseous structures is reported. A 16-year-old boy presented with a hard mass in the calvarium of posterior fossa region, fever and confusion. Radiological examination revealed an intradiploic collection with compression to cerebellum, fourth ventricle and brain stem, resulting in syringomyelia in cervical and thoracic spinal cord. After drainage and resection of the abscess wall, closure of a round dural defect was performed. The medical history of the patient and the intraoperative observations support the contention that the abscess in the reported case was a result of chronic and subclinical process of an intraosseous infection. The features concerned with diagnosis, differential diagnosis and pathogenesis of this rare entity are discussed. PMID:22235905

  17. Abscess

    MedlinePlus

    ... resistant to penicillin and penicillin-related antibiotics, most staph infections with CA-MRSA can be easily treated by ... cause serious skin and soft tissue (deeper) infections. Staph infections typically start as small red bumps or pus- ...

  18. Lung abscess in children in Harare, Zimbabwe.

    PubMed

    Tumwine, J K

    1992-10-01

    Despite the rarity of lung abscess in children, 24 patients were treated at Harare Central Hospital during the 10 year period (1979 to 1988). The bacteriology and clinical findings of the 24 patients are presented. Bacteria were isolated from 18 patients. The most frequent isolates were Staphylococcus aureus, group A beta haemolytic streptococci, and Pseudomonas aeroginosa. Most of the abscesses followed measles, empyema or an episode of aspiration. The patients were managed with bronchoscopy, physiotherapy, and appropriate antibiotics, and had a mortality of 25%. Efforts at controlling measles as well as early and appropriate management of empyema are likely to reduce the number of lung abscesses in children. PMID:1473506

  19. The management abscess of the lung.

    PubMed

    BYRON, F X

    1952-05-01

    A review of the literature raises considerable doubt as to the advisability of surgical drainage of lung abscess as a definitive procedure. The mortality rate with use of this procedure and other hazards associated with it, must now be viewed in the light of improved methods of conservative therapy - involving the use of penicillin, bronchoscopic treatment and postural drainage-by which cure can be obtained in more than 80 per cent of cases of acute abscess and in a smaller proportion of cases of chronic abscess. Another factor to be considered is the better chance for diagnosis and effective resection of associated carcinoma when conservative treatment is employed. PMID:14935878

  20. Cerebellar Staphylococcal Abscess Accompanied with High Alfa-Fetoprotein in a Young Infant

    PubMed Central

    El-Khashab, Mostafa; Zonouzi, Taraneh Hashemi; Naghani, Iman Moeini; Nejat, Farideh

    2012-01-01

    Background Brain abscess in young infants is extremely rare and usually associated with a previous history of bacterial meningitis or septicemia. Case Presentation Here we report a cerebellar abscess mimicking brain tumor with atypical clinical and paraclinical presentations. A two-month old previously well-baby boy was referred to us with persistent vomiting, strabismus and developmental regression. The brain imaging showed a right cerebellar mass with multiple small cysts inside the lesion. Elevated serum alfa-fetoprotein associated with cystic and solid posterior fossa mass proposed the preoperative diagnosis of teratoma but tumor cells were not found inside the pathology specimen. The culture of the sample was positive for staphylococcus aureus. Conclusion The interest of this case lies in the atypical features of clinical and radiological evaluations in a young infant associated with an abnormal alfa-fetoprotein level of serum. PMID:23431058

  1. Lung abscess caused by Mycoplasma pneumoniae.

    PubMed

    Omae, Takashi; Matsubayashi, Tadashi

    2015-08-01

    A 10-year-old boy with West syndrome was referred to hospital because of high fever and cough. Chest X-ray and computed tomography showed consolidation with an abscess in the right upper lobe. Laboratory data indicated cytokine storm. Various antibacterial agents and additional corticosteroid were unable to control the hypercytokinemia, which was suppressed after cyclosporine A was started. The lung abscess remained, however, and right upper lobectomy was performed. Culture from the abscess showed no growth, while polymerase chain reaction assay indicated Mycoplasma pneumoniae DNA. Serum passive agglutinin titer for M. pneumoniae was significantly elevated in the convalescent phase. These findings are strong evidence that the lung abscess was caused by M. pneumoniae infection. PMID:26177124

  2. Epidural abscess secondary to acute appendicitis.

    PubMed

    Carter, Marguerite; Meshkat, Babek; El-Masry, Sherif

    2014-01-01

    A 62-year-old man presented via the emergency department with a 1-week history of back pain, on a background of non-insulin-dependent diabetes mellitus and rectal carcinoma for which he had undergone abdominoperineal resection, chemotherapy and radiotherapy. He exhibited signs of sepsis, midline lumbar spine tenderness and reduced hip flexion. CT of the abdomen and pelvis showed a presacral collection contiguous with the tip of the appendix, and MRI lumbar spine revealed abscess invation into the epidural space extending to T9. He underwent a laparotomy with washout of the presacral abscess and appendicectomy and prolonged course intravenous antibiotic therapy. At 3 months after initial presentation he had made a full clinical recovery with progressive radiological resolution of the epidural abscess. The objective of the case report is to highlight a unique and clinically significant complication of a very common pathology (appendicitis) and to briefly discuss other intra-abdominal sources of epidural abscess. PMID:25527687

  3. Intramedullary pyogenic abscess in the conus medullaris.

    PubMed

    Hassan, M F; Mohamed, M B; Kalsi, P; Sinar, E J; Bradey, N

    2012-02-01

    Primary pyogenic abscess in the conus medullaris in a healthy adult has never been reported. An urgent MRI scan with contrast and prompt surgical evacuation may lead to good neurological recovery. PMID:22264156

  4. [Bacteriological study of oral open abscesses].

    PubMed

    Fukui, K; Kato, N; Tanaka, K; Kato, H; Watanabe, K; Tatematsu, N

    1997-12-01

    Although studies of bacteriology of closed oral abscesses have been extensively done, there are few studies on microorganisms involving open oral abscesses. We examined bacteriologically three open abscesses with precaution against bacterial contamination with oral normal flora and saliva, when sampling. The specimens were subjected to aerobic and anaerobic cultures within 2 hours after sampling. All three cases were infected with 5 to 14 species of aerobic and anaerobic bacteria; Streptococcus spp., Prevotella intermedia and other Prevotella spp. were predominant in all three cases. All six Prevotella spp. isolated were beta-lactamase producers, being resistant to beta-lactam antibiotics. These results emphasize the importance of prompt anaerobic culture for the bacteriological study of open oral abscess and the significance of nitrocefin test to detect beta-lactamase produced by oral isolates, especially Prevotella spp. PMID:9483884

  5. Klebsiella pneumoniae Liver Abscess and Metastatic Endophthalmitis.

    PubMed

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

    2016-01-01

    Introduction. Klebsiella pneumoniae is a well-known cause of liver abscess. Higher rates of liver abscess associated with Klebsiella pneumoniae are seen in Taiwan. Metastatic endophthalmitis is a common complication associated with a poor prognosis despite aggressive therapy. Case Report. We report a case of a 67-year-old Korean female with Klebsiella pneumoniae liver abscess. The patient developed metastatic endophthalmitis and ultimately succumbed to her disease despite aggressive medical and surgical treatment. Conclusion. Dissemination of Klebsiella pneumoniae is associated with significant morbidity and mortality. Liver abscesses preferably should be treated with percutaneous drainage, but surgical treatment is needed in some cases. Metastatic spread to the eye is a common complication that must be treated aggressively with intravenous antibiotics and surgical intervention if necessary. PMID:26788530

  6. Hepatic hydatid cyst presenting as cutaneous abscess.

    PubMed

    Islam, M N; Khan, N A; Haque, S S; Hossain, M; Ahad, M A

    2012-01-01

    Hydatidosis is a parasitic zoonotic echinococcal infection that affects both humans and other mammals. These diseases are common worldwide but particularly common in sheep and cattle farming regions. Anaphylaxis mediated by IgE is a serious complication of surgery or trauma which necessitates more aware of its clinical features, diagnosis and management. It is important to make a preoperative diagnosis based on the typical image findings, so that particular precaution can be taken not to rupture the lesion. A woman presented with a right upper quadrant cutaneous abscess. USG reveals multiple cystic lesions in the liver arranged in cartwheel appearance, CT disclosed a cystic lesions having daughter cysts, marginal calcifications, marginal enhancement and contiguous abdominal wall abscess, which led to a diagnosis of complicated hepatic hydatid cysts with abdominal wall abscess formation. FNAC showed scolices surrounded by chronic inflammatory cells. Abdominal wall abscess may be a presentation of hydatid liver disease. PMID:22314476

  7. [Pathogenesis and treatment of chronic lung abscesses].

    PubMed

    Ostrovskiĭ, V K; Shnaĭder, A A

    1990-01-01

    The main causes of the development of chronic abscesses of the lungs in 41 patient were the presence of the pulmonary tissue sequesters, interlobar location of a process, large (5 cm and more) diameter of the cavities. The infiltrative form of an abscess was distinguished. The process should be considered as chronic in ineffectiveness of all the types of treatment. With the use of the conservative methods, 14 patients were cured. PMID:2280521

  8. Renal Hemorrhagic Actinomycotic Abscess in Pregnancy

    PubMed Central

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

    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 infection and most importantly, avoidance of unnecessary surgical intervention. PMID:24757509

  9. Acute Abdomen Caused by Brucellar Hepatic Abscess.

    PubMed

    Koca, Yavuz Savas; Barut, Ibrahim; Koca, Tugba; Kaya, Onur; Aktas, Recep Aykut

    2016-01-01

    Brucellosis, a zoonosis that is common worldwide, is endemic in many countries, primarily those of the Mediterranean region (including Turkey). 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 spp. infection. We present a case of hepatic abscess caused by Brucella melitensis, which resembled the clinical presentation of surgical acute abdomen. PMID:26526924

  10. [Young girl with abscesses in the face].

    PubMed

    Waagsbø, Bjørn; Tofteland, Ståle; Kittang, Ole Bjørn

    2011-11-15

    Skin and soft tissue infections are most often caused by Staphylococcus aureus or various species of streptococcus. This case report summarizes the clinical features, diagnosis, treatment and clinical outcome of a facial infection presenting as multiple abscesses in a young and otherwise healthy girl. Nocardia brasiliensis was recovered from abscess aspiration, and treatment failure was eventually recognized for the recommended empirical antibiotic treatment, broad-spectrum antibiotics and surgery. PMID:22085952

  11. Pyogenic liver abscess: Changing patterns in approach

    PubMed Central

    Malik, Ajaz A; Bari, Shams UL; Rouf, Khawaja Abdul; Wani, Khurshid Alam

    2010-01-01

    AIM: To define optimum management of the pyogenic liver abscess and assess new trends in treatment. METHODS: One hundred and sixty nine patients with pyogenic liver abscess managed at Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir (India) from July 2001 to August 2006 were studied to evaluate and define the optimum treatment. RESULTS: Mortality in the surgically treated group of patients was 9.4% (12/119), while those treated non-surgically had a fatality rate of 16.66% (7/42). Multiple liver abscesses treated surgically had a surprisingly low mortality of 30%. The biliary tract (64.97%) was the most common cause of liver abscess. Multiple abscesses, mixed organisms and abscess complications are all associated with a significantly increased mortality. However, the lethality of the primary disease process was the most important factor in determining survival. CONCLUSION: Transperitoneal surgical drainage and antibiotics are the mainstay of treatment. Percutaneous drainage is recommended for high risk patients only. PMID:21206721

  12. Pancreatic Lesion: Malignancy or Abscess?

    PubMed

    Shulik, Oleg; Cavanagh, Yana; Grossman, Matthew

    2016-01-01

    BACKGROUND Pancreatic abscesses are rare. They may be seen in patients with pancreatic inflammation or pancreatitis. Patients with pancreatic abscesses may have abdominal pain, fever, chills, and nausea/vomiting or an inability to eat. Presentation with alternate symptomatology is extremely unusual. CASE REPORT A 67-year-old Asian male presented with painless, afebrile obstructive jaundice and a CA 19-9 of 1732 IU. He was found to have a 3.1×2.4 cm low-density lesion in the head of the pancreas and the right lobe of the liver, suggesting malignancy. Surgical management was considered, however additional diagnostic workup, including an endoscopic retrograde cholangiopancreatography (ERCP), was performed to complete staging of the presumed mass. A smooth, 3-cm-long, tapering stricture was found it the common bile duct. It was stented from the common hepatic duct to the duodenum. Subsequent endoscopic ultrasound (EUS) evaluation of the pancreatic head lesion revealed a drainable fluid collection that was aspirated and found to contain pyogenic material on pathology. The patient's symptoms resolved, and he was subsequently managed conservatively. A repeat ERCP confirmed complete resolution of the previously visualized cystic lesion. Interestingly, laboratory values showed concomitant normalization of CA 19-9 to 40 IU. CONCLUSIONS EUS-guided biopsy is not widely regarded as a required step before surgery, in the management of patients with pancreatic masses. It is generally reserved for determination of resectability or staging, and only utilized when clinically indicated. However, this practice may be associated with an inherently significant risk of misdiagnosis and subsequent unnecessary surgery, as illustrated by this case. Malignancy was initially suspected in our patient and surgical resection was recommended. Endoscopic measures were only pursued to complete staging. We propose that EUS-guided biopsy may be a crucial diagnostic step in the management algorithm of pancreatic lesions in selected patients. In addition, we encourage consideration of nonmalignant pancreatic collections in the differential diagnosis of pancreatic masses, especially when present in patients with diabetes mellitus. PMID:27188399

  13. Hepatic abscess: Diagnosis and management.

    PubMed

    Lardière-Deguelte, S; Ragot, E; Amroun, K; Piardi, T; Dokmak, S; Bruno, O; Appere, F; Sibert, A; Hoeffel, C; Sommacale, D; Kianmanesh, R

    2015-09-01

    Microbial contamination of the liver parenchyma leading to hepatic abscess (HA) can occur via the bile ducts or vessels (arterial or portal) or directly, by contiguity. Infection is usually bacterial, sometimes parasitic, or very rarely fungal. In the Western world, bacterial (pyogenic) HA is most prevalent; the mortality is high approaching 15%, due mostly to patient debilitation and persistence of the underlying cause. In South-East Asia and Africa, amebic infection is the most frequent cause. The etiologies of HA are multiple including lithiasic biliary disease (cholecystitis, cholangitis), intra-abdominal collections (appendicitis, sigmoid diverticulitis, Crohn's disease), and bile duct ischemia secondary to pancreatoduodenectomy, liver transplantation, interventional techniques (radio-frequency ablation, intra-arterial chemo-embolization), and/or liver trauma. More rarely, HA occurs in the wake of septicemia either on healthy or preexisting liver diseases (biliary cysts, hydatid cyst, cystic or necrotic metastases). The incidence of HA secondary to Klebsiella pneumoniae is increasing and can give rise to other distant septic metastases. The diagnosis of HA depends mainly on imaging (sonography and/or CT scan), with confirmation by needle aspiration for bacteriology studies. The therapeutic strategy consists of bactericidal antibiotics, adapted to the germs, sometimes in combination with percutaneous or surgical drainage, and control of the primary source. The presence of bile in the aspirate or drainage fluid attests to communication with the biliary tree and calls for biliary MRI looking for obstruction. When faced with HA, the attending physician should seek advice from a multi-specialty team including an interventional radiologist, a hepatobiliary surgeon and an infectious disease specialist. This should help to determine the origin and mechanisms responsible for the abscess, and to then propose the best appropriate treatment. The presence of chronic enteric biliary contamination (i.e., sphincterotomy, bilio-enterostomy) should be determined before performing radio-frequency ablation and/or chemo-embolization; substantial stenosis of the celiac trunk should be detected before performing pancreatoduodenectomy to help avoid iatrogenic HA. PMID:25770745

  14. Imported Amoebic Liver Abscess in France

    PubMed Central

    Cordel, Hugues; Prendki, Virginie; Madec, Yoann; Houze, Sandrine; Paris, Luc; Boure, Patrice; Caumes, Eric; Matheron, Sophie; Bouchaud, Olivier

    2013-01-01

    Background Worldwide, amoebic liver abscess (ALA) can be found in individuals in non-endemic areas, especially in foreign-born travelers. Methods We performed a retrospective analysis of ALA in patients admitted to French hospitals between 2002 and 2006. We compared imported ALA cases in European and foreign-born patients and assessed the factors associated with abscess size using a logistic regression model. Results We investigated 90 ALA cases. Patient median age was 41. The male:female ratio was 3.5?1. We were able to determine the origin for 75 patients: 38 were European-born and 37 foreign-born. With respect to clinical characteristics, no significant difference was observed between European and foreign-born patients except a longer lag time between the return to France after traveling abroad and the onset of symptoms for foreign-born. Factors associated with an abscess size of more than 69 mm were being male (OR?=?11.25, p<0.01), aged more than 41 years old (OR?=?3.63, p?=?0.02) and being an immigrant (OR?=?11.56, p?=?0.03). Percutaneous aspiration was not based on initial abscess size but was carried out significantly more often on patients who were admitted to surgical units (OR?=?10, p<0.01). The median time to abscess disappearance for 24 ALA was 7.5 months. Conclusions/Significance In this study on imported ALA was one of the largest worldwide in terms of the number of cases included males, older patients and foreign-born patients presented with larger abscesses, suggesting that hormonal and immunological factors may be involved in ALA physiopathology. The long lag time before developing ALA after returning to a non-endemic area must be highlighted to clinicians so that they will consider Entamoeba histolytica as a possible pathogen of liver abscesses more often. PMID:23951372

  15. Gas Forming a V-Shape Aluminum Sheet into a Trough of Saddle-Contour

    NASA Astrophysics Data System (ADS)

    Lee, Shyong; Lan, Hsien-Chin; Lee, Jye; Wang, Jian-Yih; Huang, J. C.; Chu, Chun Lin

    2012-11-01

    A sheet metal trough of aluminum alloys is manufactured by gas-forming process at 500 °C. The product with slope walls is of ~1.2 m long and ~260 mm opening width, comprising two conical sinks at two ends. The depth of one sink apex is ~350 mm, which results in the depth/width ratio reaching 1.4. To form such a complex shape with high aspect ratio, a pre-form of V-shape groove is prepared prior to the gas-forming work. When this double concave trough is turned upside down, the convex contour resembles the back of a twin hump camel. The formability of this configuration depends on the gas pressurization rate profile, the working temperature, material's micro-structure, as well as pre-form design. The latter point is demonstrated by comparing two aluminum alloys, AA5182 and SP5083, with nearly same compositions but very different grain sizes.

  16. Prostatic abscess: case report and review of the literature.

    PubMed

    Porfyris, Orestis; Kalomoiris, Paraskevas

    2013-09-01

    We report a case of prostatic abscess in a 52 year old male with a history of diabetes mellitus. The abscess was treated successfully with surgical drainage by transurethral unroofing of the cavity of the abscess. The use of transrectal ultrasound is valuable in the diagnosis, treatment and follow up of the abscess, while drainage is usually necessary for the treatment, which can be done by transrectal, transperineal and transurethral route. PMID:24085239

  17. Subhepatic Sterile Abscess 10 Years After Laparoscopic Cholecystectomy

    PubMed Central

    Bartels, Anne K.; Zamora, Jose Gonzales

    2015-01-01

    We present a case of a large, sterile, subhepatic abdominal wall abscess secondary to foreign body reaction to dropped gallstones during laparoscopic cholecystectomy performed 10 years ago. Dropped gallstones are common complications of laparoscopic cholecystectomy, but they rarely result in abscess formation. When abscesses do occur, they may present a few months to a few years after surgery. It is important to recognize dropped gallstones as an etiology for subhepatic abscess in patients with history of laparoscopic cholecystectomy. PMID:26157931

  18. Bacteriology of dental abscesses of endodontic origin.

    PubMed

    Williams, B L; McCann, G F; Schoenknecht, F D

    1983-10-01

    Aspirates have been cultured from 10 dental abscesses of endodontic origin, all of which had penetrated beyond the bony alveolus to produce fluctuant swelling. Sampling was by syringe aspiration. Strict anaerobic techniques, including the use of an anaerobic chamber, were used for serial dilution and plating. Randomly selected colonies (100) from each culture were purified, characterized, and identified. Seventy percent of the bacterial isolates were either strict anaerobes or microaerophilic. One abscess yielded a pure culture of a viridans streptococcus, Streptococcus milleri. Streptococcus intermedius dominated the flora in a second abscess. The common oral streptococcus, Streptococcus sanguis, constituted only 2% of the isolates from one additional infection. Fusobacterium nucleatum, Bacteroides melaninogenicus, other Bacteroides including B. oralis and B. ruminicola, anaerobic diphtheroids, Peptostreptococcus micros, and Staphylococcus epidermis were other predominant isolates. PMID:6630460

  19. Renal Abscess Caused by Salmonella Typhi

    PubMed Central

    Kaur, Amarjeet; Sarma, Smita; Kumar, Navin; Sengupta, Sharmila

    2015-01-01

    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. PMID:26417164

  20. Muscle Abscess due to Salmonella Enterica.

    PubMed

    Akkoyunlu, Yasemin; Ceylan, Bahadir; Iraz, Meryem; Elmadag, Nuh Mehmet; Aslan, Turan

    2013-07-01

    Non typhoidal Salmonellae spp. causes clinical symptoms especially in neonates, infants, aged and immunocompromised patients. Hematogenous dissemination may occur in complicated cases whereas the formation of abscess is rare. A 61-year old woman presented to our hospital with pain and a mass in her left arm, without fever and leukocytosis. She was using methotrexate, corticosteroids and quinine for rheumatoid arthritis. She had a history of cervix cancer and was given radiotherapy and chemotherapy 3 years ago. Upon physical examination and magnetic resonance imaging, the mass was considered as an abscess and was surgically drained. Salmonella enterica spp. enterica was yielded in the culture of the drainage material. Ceftriaxon 2g/day was started intramuscularly and continued for 4 weeks. Salmonellosis is usually a self-limited disease, generally restricted to gastrointestinal tract and acquired following food poisoning. Management of Salmonella abscess requires a combination of antibiotherapy, surgical drainage and eradication of primary foci. PMID:24396582

  1. Nephrobronchial fistula and lung abscess secondary to Xanthogranulomatous pyelonephritis.

    PubMed

    Uppe, Abhay; Nikalji, Ravindra; Dubey, Manish; Kadu, Nilesh

    2015-01-01

    There are multiple causes of lung abscess, but the differential rarely includes pyelonephritis as a primary cause leading to lung abscess resulting from the development of a nephrobronchial fistula. The patient had no urinary symptoms or abdominal pain and the etiology of lung abscess was only incidentally discovered after chest CT revealed extension of pleural fluid below the diaphragm. PMID:26180394

  2. Corticosteroid Therapy for Liver Abscess in Chronic Granulomatous Disease

    PubMed Central

    Leiding, Jennifer W.; Freeman, Alexandra F.; Marciano, Beatriz E.; Anderson, Victoria L.; Uzel, Gulbu; Malech, Harry L.; DeRavin, SukSee; Wilks, David; Venkatesan, Aradhana M.; Zerbe, Christa S.; Heller, Theo

    2012-01-01

    Liver abscesses in chronic granulomatous disease (CGD) are typically difficult to treat and often require surgery. We describe 9 X-linked CGD patients with staphylococcal liver abscesses refractory to conventional therapy successfully treated with corticosteroids and antibiotics. Corticosteroids may have a role in treatment of Staphylococcus aureus liver abscesses in CGD. PMID:22157170

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

    PubMed Central

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

    2016-01-01

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

  4. Diagnostic strategy in evaluation of renal abscess

    SciTech Connect

    Godec, C.J.; Tsai, S.H.; Smith, S.J.; Cass, A.S.

    1981-12-01

    The diagnosis of renal abscess is still a challenging problem. Early manifestations are usually nonspecific and nonlocalizing. Clinical picture, laboratory data, and intravenous pyelogram do not always differentiate between inflammatory lesions and neoplastic processes. Two cases with bilateral, metachronous renal abscesses are presented. The use of 111Indium scan is probably the major recent advance used for unmasking this inflammatory lesion. Sonography, computerized tomography scan, and even arteriography are sometimes necessary to establish reliable preoperative diagnosis. The diagnostic strategy for a systematic approach to the lesion is outlined.

  5. Acute abdomen caused by brucellar hepatic abscess.

    PubMed

    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. PMID:17962133

  6. Omental and extraperitoneal abscesses complicating cholecystocolic fistula

    PubMed Central

    Gardiner, K

    2003-01-01

    Background Acute cholecystitis resolves with conservative treatment in most patients, but empyema or perforation of an ischaemic area may develop, resulting in a pericholecystic abscess, bile peritonitis or a cholecysto-enteric fistula. Case outline A 63-year-old man presented with extraperitoneal and omental abscess formation complicating a cholecystocolic fistula secondary to gallbladder disease. Histological examination of the gallbladder and omentum showed xanthogranulomatous inflammation. Conclusion A detailed literature review failed to demonstrate a previous report of this combination of rare complications of gallbladder disease. PMID:18332986

  7. Management of superior subperiosteal orbital abscess.

    PubMed

    Gavriel, Haim; Jabrin, Basel; Eviatar, Ephraim

    2016-01-01

    A superior subperiosteal orbital abscess (SSPOA) is a collection of purulent material between the periorbit and the superior bony orbital wall, and is typically a complication of frontal sinusitis. SSPOA is characteristically managed by classic external surgical drainage. The aim of our study was to assess the role of surgical intervention in SSPOA. A retrospective medical chart review of patients diagnosed with SSPOA secondary to rhinosinusitis between the year 2005 and 2013 was conducted. Collected data included age, gender, co-morbidity, clinical presentation, prior antibiotic management, CT scans, surgical approach, outcome and complications. Six patients were included in our study, three males and three females with a mean age of 22.8 (range 9-58). Two patients were treated with amoxicillin clavulanic acid for 3days prior to admission. Only the youngest patient with the smallest abscess responded successfully to conservative treatment, while the rest were managed surgically: three patients were treated successfully by the endonasal endoscopic approach and two patients were treated by utilizing the combined endonasal endoscopic and external approach. In patients who underwent the combined approach, the abscess was located in a more antero-lateral position than those treated endonasal endoscopically only. The location of a SSPOA dictates the surgical approach. The most antero-lateral SSPOAs should be drained by the combined approach, while more posterior abscesses should be approached endoscopically. Furthermore, a small SSPOA is first to be reported to resolve with conservative treatment. Level 4 (case series). PMID:25700832

  8. A rare cause of nasal septal abscess.

    PubMed

    Waterhouse, David; Hornibrook, Jeremy

    2013-04-01

    We describe a patient with mid-facial pain and nasal obstruction due to a nasal septal abscess (NSA) complicating an occult fungal ball of the sphenoid sinus. We highlight the importance of suspecting unusual pathology in patients with NSA and no trauma history. PMID:23793181

  9. Periappendicular Abscess Presenting within an Inguinal Hernia

    PubMed Central

    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

  10. Multiple intracranial abscesses: Heralding asymptomatic venosus ASD.

    PubMed

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

    2013-10-01

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

  11. Liver abscess caused by tuberculosis and melioidosis.

    PubMed

    Azali, Hafiz Yafee Amar; Norly, Salleh; Wong, Leh Meng; Tan, Kia Sin; Safian, Naim Muhammad

    2007-04-01

    We report an unusual co-existence of Burkholderia pseudomallei and acid fast bacilli in a young Malay gentleman with liver abscess. He was treated with antibiotics and surgical drainage. This phenomenon has not been reported in previous literature and the dilemma of its management is discussed. PMID:17475585

  12. Melioidosis presenting as spinal epidural abscess.

    PubMed

    Ganesan, D; Puthucheary, S D; Waran, V

    2003-12-01

    Central nervous system melioidosis is an unusual infection in humans. This article reports a case of melioidosis presenting as an acute spinal epidural abscess. A discussion of this case and its management together with a brief review of melioidosis of the central nervous system is presented. PMID:14756491

  13. [Amebic liver abscess of unusual presentation].

    PubMed

    Berthoud, S; Rime, F; Buffle, P

    1976-06-12

    A 35-year-old male who had travelled extensively in the tropics presented with severe anorexia and vomiting associated with fever of 39-40 degrees C during a 4-day period. The clinical findings were entirely negative. In 1973, he had been given metronidazole for amebic dysentery, since when recurrent attacks of diarrhea and abdominal pain had been treated with iodoquinoleines. Stool examination was negative for amebae. Liver scan revealed a suspect "expansive process" in the right lobe. The presumptive diagnosis of amebic abscess was made and metronidazole therapy was started. In less than 24 h the patient became afebrile. The abscess was confirmed by a further liver scan. The definitive diagnosis of amebiasis was established 16 days later when the immunofluorescence level, which had been previously negative, became positive 1/480. This case demonstrates the dangers of the indiscriminate use of iodoquinoleines in patients who have travelled in tropical countries. The amebic liver abscess may be silent locally while causing systemic manifestations such as fever. Early treatment of hepatic amebiasis is recommended even with a presumptive diagnosis. Serological tests during the development of an amebic abscess may be negative and should be repeated after several days of therapy. PMID:996499

  14. [Case of the abscess type cutaneous nocardiosis].

    PubMed

    Iketani, Yuki; Hata, Yasuki; Yamamoto, Nao; Oguri, Toyoko

    2014-01-01

    A 58-year-old woman, who had write infull (ITP) and angina, developed a rash similar to an insect bite on the left Achilles tendon one week before visiting our hospital. The rash evolved into pustule. Three or 4 days later she had redness and swelling on her left leg, which was pain full.She went to a clinic, where she was given cefdinir (CFDN) and referred to our hospital.When she came to our hospital, she had an abscess on her left heel, and linear redness and heat along lymph ducts in her left leg and lymph node swelling in her left groin.We diagnosed bacterial lymphangitis, and gave her cefcapene (CFPN-PI) and gentamicin (GM) ointment. Six days later, she recovered.Later abscess culture yielded an organism which was suspected to be Nocardia sp. We identified the organism as Nocardia brasiliensis and diagnosed abscess-type cutaneous nocardiosis. We administered sulfametthoxazole / trimethoprim for one week and checked her whole body on CT, which revealed no lesions.This case was considered to be cutaneous nocardiosis, for which beta-lactam antimicrobial drug or external application of GM ointment would be effective, and abscess-type cutaneous nocardiosis, which recovered with medical treatment for a general bacterial infection was suggested. PMID:24682099

  15. Role of Sadyo Vamana in dental abscess (danta arbuda)

    PubMed Central

    Vijayalakshmi, Narra

    2012-01-01

    Sadyo Vamana is a type of purificatory measure mentioned in Ayurveda, which to expel the pus and morbid factors present in a dental abscess without opening it. However, Sadyo Vamana's role in fever and pus filled dental abscess has not been reported so far. I report a case of dental abscess with fever. A 24-year-old male patient with a pus filled dental abscess. His fever and dental abscess didn’t respond to antibiotic and analgesic treatment for 10 days. The patient was given Sadyo Vamana (instant therapeutic emesis) to expel the accumulated pus in dental abscess without opening it. The patient got complete relief from fever and dental abscess after Sadyo Vamana. The patient not gave internal medication. PMID:24167336

  16. Etiological agents and predisposing factors of intracranial abscesses in a Greek university hospital.

    PubMed

    Sofianou, D; Selviarides, P; Sofianos, E; Tsakris, A; Foroglou, G

    1996-01-01

    The bacteriology for 21 patients with brain abscesses is presented and correlated with their predisposing conditions. Chronic otomastoiditis was the most common predisposing factor, and the overall most frequent infected sites were the frontal and temporal regions. Gram-negative non-sporeforming anaerobes of the genus Bacteroides and Fusobacterlum followed by aerobic streptococci were the predominant pathogens. Enterobacteria were only identified in postcraniotomy abscesses, while a substantial number of fastidious species was detected in suppurations related to congenital heart disease. Altogether, anaerobes alone were recovered in seven patients, aerobes alone in six, and mixed aerobes and anaerobes in four patients. These findings confirm the predominant role of anaerobes in the etiology of intracranial suppurations. PMID:8740108

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

    SciTech Connect

    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.

  18. Ultrasonographic findings in 11 cows with a hepatic abscess.

    PubMed

    Braun, U; Pusterla, N; Wild, K

    1995-09-16

    The livers of 11 cows with a hepatic abscess were examined ultrasonographically. An abscess was observed in only one intercostal space in three cows, in two spaces in five, in three spaces in two, and in four adjacent intercostal spaces in one cow. In three cows the abscess was imaged in the caudodorsal aspect of the liver in the 11th and 12th intercostal space, in five cows the abscess was visible in the central part of the liver in the ninth and 10th intercostal space and in the three other cows the abscess was observed in the cranioventral region of the liver in the sixth, seventh and eighth intercostal spaces. The abscess had a distinct and well developed capsule in nine cows. The content of the abscess was echogenic in six cows, anechoic in two, and echogenic with hyperechoic foci in three. In four cows, the content of the abscess was partitioned by echogenic septa. In one cow, the echogenic content of the abscess was surrounded by a narrow anechoic rim of fluid. The diameter of the abscess was 5 to 10 cm in four cows, 11 to 15 cm in four, and more than 15 cm in three. In every case the diagnosis was confirmed by centesis and aspiration of the abscess which yielded pus. Ten of the cows were slaughtered after being examined and the ultrasonographic findings were confirmed. In addition, 10 of the cows had other lesions which included traumatic reticuloperitonitis, abscessation of the reticulum, thrombosis of the caudal vena cava, bronchopneumonia with abscessation, reticulo-omasal stenosis, ascites and suppurative omental bursitis. PMID:8533222

  19. Breast abscess caused by penicillin resistant Pneumococci

    PubMed Central

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

    2011-01-01

    Breast abscess is mostly caused by Staphylococcus aureus. A 26-year-old immunocompetent lady was admitted with breast abscess. Incision and drainage (I/D) was done and Pneumococci were isolated from the drained pus. The patient was earlier treated with Augmentin which was later changed to linezolid after testing for antibiotic susceptibility. This strain showed a high level of resistance to penicillin. It had been noticed that there was a slow increase in the number of penicillin resistant Pneumococci isolated in our hospitals. The increase in penicillin-resistant Pneumococci correlates with the intensive use of beta-lactam antibiotics. Hence, antibiotics should be used judiciously, avoiding their use particularly in mild self-limiting upper respiratory infections. Attention therefore, should focus on monitoring resistance in Pneumococci to prevent mortality and morbidity associated with this organism, which continues to take a heavy toll on children and the elderly. PMID:21897917

  20. [Pasteurella multocida meningitis with cerebral abscesses].

    PubMed

    Nguefack, S; Moifo, B; Chiabi, A; Mah, E; Bogne, J-B; Fossi, M; Fru, F; Mbonda, E; Djientcheu, V-P

    2014-03-01

    Pasteurella multocida is classically responsible for local soft tissue infections secondary to dog bites or cat scratches. It can be responsible for meningitis in infants and elderly persons. We report the case history of a 5-year-old male child admitted to our pediatric unit for meningitis. Cerebrospinal fluid analysis revealed an infection with P. multocida. The suspected mode of contamination was either from the saliva of a pet dog or through an unnoticed skull fracture sustained after an accident 1 year prior to the occurrence of meningitis. In spite of the neurologic complication (cerebral abscess), the progression was favorable after drainage of the abscess, 5 weeks of parenteral treatment, and 3 weeks of oral antibiotic therapy. Meningitis due to Pasteurella sp. is rare and can lead to neurologic complications. The notion of bites or scratches can be absent and the mode of contamination is sometimes difficult to unveil. PMID:24457110

  1. [Treatment of giant lung abscesses in children].

    PubMed

    Avilova, O M; Samaĭ, A G; Oleĭnik, V S

    1984-08-01

    The method of occlusion of the draining bronchus in combination with a one-step percutaneous drainage of the purulent cavity by the Monaldi principle was used in 12 children for the treatment of giant pulmonary abscesses. It was shown that the proposed method unlike traditional procedures allows effective sanitation to be performed. It relieves symptoms of intrathoracic strain and thereby allows avoiding operations at the height of purulent intoxication. No complications and lethality followed the treatment. PMID:6093318

  2. [Multiple hepatic abscesses: a pediatric case report].

    PubMed

    Zanolini, C; Gallio, F; Del Piano, A; Galat, F

    1995-01-01

    The Authors describe the case of an immunologically healthy 14 year old boy presenting a hepatic infection with multiple abscesses. This case is of particular interest because of its rarity in Pediatrics. Probable etiologies, pathogenic mechanisms and treatments are discussed. The Authors underline the usefulness of ultrasonography as a diagnostic tool and as a non-invasive means of following the course of the disease. PMID:7739934

  3. A psoas abscess caused by Propionibacterium propionicum.

    PubMed

    Yonetani, Shota; Ohnishi, Hiroaki; Araki, Koji; Hiroi, Megumi; Takagi, Yasushi; Ichimura, Shoichi; Watanabe, Takashi

    2014-10-01

    Pelvic actinomycosis-like disease due to Propionibacterium propionicum has been very rare and only a few cases have been reported in the literature. We herein report a probable first case of a psoas abscess caused by P. propionicum. Since P. propionicum is indistinguishable from Actinomyces israelii by morphological features or routine biochemical tests, 16S rRNA gene sequencing was useful to discriminate these two species in this case. PMID:25129856

  4. Klebsiella pneumoniae Liver Abscess: An Emerging Disease.

    PubMed

    Fazili, Tasaduq; Sharngoe, Calden; Endy, Timothy; Kiska, Deana; Javaid, Waleed; Polhemus, Mark

    2016-03-01

    Most of the cases of Klebsiella pneumoniae liver abscess reported early on were from Asia, predominantly Taiwan, with a significant number of patients being middle aged diabetic men, and developing metastatic complications, especially endophthalmitis. The entity is now being increasingly recognized in the United States. In this article, the authors review those reported cases, and also the literature regarding the pathophysiology of this intriguing syndrome. PMID:26992260

  5. Perianal Abscess and Proctitis by Klebsiella pneumoniae

    PubMed Central

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

    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. PMID:25691848

  6. Intraperitoneal tuberculous abscess: Computed tomography features

    PubMed Central

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

    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. PMID:26435779

  7. Clinics in diagnostic imaging (57). Melioidotic prostatic abscess.

    PubMed

    Yip, S K; Ang, B S; Tan, J

    2001-01-01

    A 46-year-old previously healthy man presented with urosepsis and lower urinary tract obstruction. Both urine and blood cultures grew Burkholderia pseudomallei. Intravenous Ceftazidime failed to control the infection. Prostatic abscess formation was first detected by transrectal ultrasonography, and the extent was subsequently delineated by computed tomography. The abscess was drained by transurethral resection, which served to eradicate a possible persistent focus of infection. The diagnosis and management of prostatic abscess, and Melioidosis infection, are discussed. PMID:11361238

  8. [Laparoscopy-guided liver abscess drainage of multiple large formations].

    PubMed

    Trangbæk, Rune Munch; Arnesen, Regnar Bøge; Støckel, Mikael

    2015-01-12

    A 50-year-old woman was admitted with abdominal pain, vomiting, fever and diarrhoea. She had increased white blood cell count and increased level of liver enzymes. A CT scan revealed 13 abscesses in the liver and tests showed Streptococcus angin-osus. Investigation showed no entry point for bacteria. The woman underwent laparoscopic investigation, and the absces-ses were completely drained preoperatively without installation of catheter in spite of large abscess formations. After 26 days of admittance with antibiotic treatment she was discharged and check-up revealed no re-formation of the abscesses. PMID:25613096

  9. Bacteriologic and histologic studies of hepatic abscesses in cattle.

    PubMed

    Lechtenberg, K F; Nagaraja, T G; Leipold, H W; Chengappa, M M

    1988-01-01

    Twenty-eight abscessed livers were collected from feedlot cattle at an abattoir; specimens were obtained from 49 abscesses for bacteriologic culture and for histologic examination. Cultural procedures included techniques to enumerate and isolate facultative and obligate anaerobic bacteria. Anaerobic bacteria were isolated from all 49 abscesses, whereas facultative bacteria were isolated from only 22. Mean bacterial counts for anaerobic and facultative bacteria were 3 X 10(8) and 8 X 10(8) bacteria/g of purulent material, respectively. Fusobacterium necrophorum, the only anaerobe isolated, was detected in 100% of the abscesses. Fusobacterium necrophorum biotype A was isolated from 57% of the abscesses (in pure culture from 75%), and F necrophorum biotype B was isolated from 47% of the abscesses (from 96% with mixed infections). Corynebacterium pyogenes was the predominant facultative bacterium isolated. Histologic changes in abscesses were qualitatively similar; abscesses were pyogranulomatous, with a necrotic center surrounded by zones of inflammatory tissue. However, the severity of lesions varied, depending on the F necrophorum biotype involved. Portal triad fibrosis and bile-duct proliferation were most severe in biotype A and mixed biotype B infections and less severe in abscesses from which biotype B was isolated in pure culture. PMID:3354968

  10. Pituitary abscess in an adolescent girl: a case report and review of the literature.

    PubMed

    Zegarra-Linares, Ricardo; Moltz, Kathleen C; Abdel-Haq, Nahed

    2015-03-01

    We report the case of a 15-year-old girl who presented with a history of recurrent bitemporal headaches for the last 2 months. In the prior few days, she complained of neck pain, emesis, phonophobia and photophobia, but no fever. Additional symptoms included polydipsia, polyuria and weight gain in the last year. Magnetic resonance imaging (MRI) of the brain demonstrated a cystic sellar and suprasellar mass with peripheral enhancement. Cerebrospinal fluid studies showed pleocytosis. Serum hormone levels were consistent with panhypopituitarism. Transnasal sphenoidotomy was performed, and 2 mL of purulent material was drained, confirming the diagnosis of pituitary abscess. The patient completed 6 weeks of parenteral antibiotics. She improved but continued to require home hormonal replacement therapy. A repeated MRI 3 months later showed abscess resolution. In addition to tumors, pituitary abscess should be considered in children who present with headache and panhypopituitarism, particularly in those who present with signs of meningeal inflammation. Prolonged parenteral antibiotics and surgical drainage are effective. PMID:25153562

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

    PubMed

    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. PMID:26572872

  12. Candida sepsis originating from bulbar abscess of the penis.

    PubMed

    Huuskonen, J; Aaltomaa, S

    2006-01-01

    We describe a patient with a very unusual penile abscess. Antibiotic treatment for Clostridium sordellii and Candida albicans infection and drainage of pus was curative. We propose that the penile abscess may have been an unusual manifestation of a rectal fistula. PMID:16916779

  13. Splenic Abscess due to Brucella Melitensis - A Rare Pediatric Complication

    PubMed Central

    Parande, Aisha M; Mantur, B G; Kore, Mahesh; Palled, Eranna

    2010-01-01

    Splenic abscess due to Brucella species is an extremely rare complication especially in acute illness. Here we report a case of splenic abscess caused by Brucella melitensis biotype 1 in a child with acute infection who was successfully treated with only antibiotics. PMID:21346907

  14. 9 CFR 311.14 - Abrasions, bruises, abscesses, pus, etc.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Abrasions, bruises, abscesses, pus, etc. 311.14 Section 311.14 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT... PARTS § 311.14 Abrasions, bruises, abscesses, pus, etc. All slight, well-limited abrasions on the...

  15. Penile Abscess: A Case Report and Review of Literature*

    PubMed Central

    Garcia, Cindy; Winter, Matthew; Chalasani, Venu; Dean, Thomas

    2014-01-01

    A case of penile abscess after amphetamine injection into the penis is reported. A 45-year-old male patient was successfully treated with surgical drainage and antibiotics. There were no 3-month consequences of treatment at follow-up, and the patient maintained potency, without any penile deformity. The aetiology, diagnosis, and management of penile abscesses are discussed. PMID:26955536

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

    PubMed

    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. PMID:24712182

  17. Post-partum pyogenic abscess containing Ascaris lumbricoides

    PubMed Central

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

    2013-01-01

    We report an unusual case of multiple pyogenic liver abscesses containing Ascariasis lumbricoides in a 35-year-old post-partum female who had delivered 1 month back. Open drainage of liver abscess along with liver worm was done. Patient did well post-operatively. PMID:23961448

  18. Intracranial abscesses associated with chronic suppurative otitis media.

    PubMed

    Seven, Huseyin; Coskun, Berna Uslu; Calis, Asli B; Sayin, Ibrahim; Turgut, Suat

    2005-10-01

    Intracranial abscesses are serious complications of chronic suppurative otitis media (COM). This study included 32 patients presenting with intracranial abscesses from 780 patients hospitalized for treatment of COM. The 32 patients had 59 intracranial complications. Perisinus abscess (13 of 32) was the most common intracranial abscess, followed by temporal lobe abscess (8 of 32), epidural abscess (7 of 32), cerebellar abscess (6 of 32) and subdural empyema (2 of 32). Headache (93%), fever (87%) and altered mental status (62%) were the most common presenting symptoms and signs, along with symptoms of COM. All patients were treated with intravenous antibiotics and canal wall down mastoidectomy. Cholesteatoma with granulation tissue and bony defects at the sinus plate and/or dural plate were seen in most of the patients. Gram negative bacilli and anaerobes were the most common organisms cultured from the abscesses. Three patients had neurological sequels. One patient died. The early diagnosis of these complications requires a high index of suspicion and imaging studies. A multidisciplinary and coordinated approach is important for the management of these patients. PMID:15959795

  19. Blind omphalitis and palatine abscess in a bull calf

    PubMed Central

    2005-01-01

    Abstract Neurological, respiratory, and gastrointestinal signs in a 2-month-old veal calf were suggestive of a possible herd problem. Autopsy revealed an umbilical abscess, an abscess on the soft palate, and mild chronic enteritis and pulmonary edema. Virologic and bacteriologic investigations did not provide a definitive diagnosis. PMID:16018566

  20. Genomewide association study of liver abscess in beef cattle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fourteen percent of U.S. cattle slaughtered in 2011 had liver abscesses. As a result, these cattle have reduced carcass weight and poor carcass quality resulting in reduced value. Liver abscess can result from a common bacterial cause Fusobacterium necrophorum, which inhabits rumen lesions caused ...

  1. Cerebral Candidal Abscess and Bovine Viral Diarrhoea Virus Infection in an Aborted Bovine Fetus.

    PubMed

    Vilander, A C; Niles, G A; Frank, C B

    2016-01-01

    Candida species are opportunistic fungi associated with immunosuppression and are the most commonly isolated fungal pathogens from the human central nervous system. Invasive candidiasis is reported uncommonly in animals and there have only been two reports of candidal infection of the brain. This report presents a case of a cerebral candidal abscess in an aborted late-term calf co-infected with bovine viral diarrhoea virus. Candida etchellsii, a species not previously identified as pathogenic, was identified as the causative agent by polymerase chain reaction. PMID:26895887

  2. Metastatic spinal abscesses from diabetic foot osteomyelitis.

    PubMed

    Shaho, Shang; Khan, Shaila; Huda, M S Bobby; Chowdhury, Tahseen Ahmad

    2014-01-01

    A 66-year-old man with long-standing type 2 diabetes, nephropathy and neuropathy was admitted acutely with an infected left big toe neuropathic ulcer, with underlying osteomyelitis. His condition rapidly deteriorated with sepsis and right lobar pneumonia. Microbiology grew methicillin-sensitive Staphylococcus aureus. Shortly into his admission, he developed flaccid paraparesis, and an MRI showed multiple epidural abscesses with likely cord infarction, not amenable to surgical intervention. His sepsis resolved, but his paraparesis remained severe, requiring spinal rehabilitation. PMID:24920514

  3. Corpus cavernosum abscess after Winter procedure performance

    PubMed Central

    Paladino, Joao Roberto; Nascimento, Fabio Jose; Gromatsky, Celso; Pompeo, Antonio Carlos Lima

    2014-01-01

    A 23-year-old male patient with sickle-cell disease reported his third episode of priapism complicated by the presence of a corpus cavernosum abscess after the performance of a Winter procedure 20 days prior to his presentation. While in hospital for 11 days, two penile needle aspirations and three surgical drainages were performed with associated antibiotic therapy. He evolved with erectile dysfunction refractory to drug therapy and his infectious condition improved. An early penile prosthesis implantation followed after the use of a vacuum pump in an attempt to decrease the fibrotic process of the corpora cavernosa. Final results were positive. PMID:24515231

  4. Otogenic cerebellar abscess: a case report.

    PubMed

    Richter, Gresham T; Smith, Jason A; Dornhoffer, John L

    2009-04-01

    This case report describes the gradual deterioration of a healthy, highly functioning man who initially presented with a draining right ear. The patient's indolent neurologic decline and referral to an otologist ultimately led to the diagnosis and treatment of an otogenic cerebellar abscess, an increasingly rare intracranial complication of otitis media. We report this case to illustrate that severe complications of chronic otitis media still occur in the United States, to stress the importance of clinical suspicion in the postantibiotic era, and to review the literature regarding the most appropriate time to perform the otologic portion of the surgery. PMID:19358116

  5. Tubo-Ovarian Abscess: Pathogenesis and Management

    PubMed Central

    Osborne, Newton G.

    1986-01-01

    That a female patient with abdominal pain is often considered to have pelvic inflammatory disease until proven otherwise is ubiquitous in the medical literature. This view is dangerous and should be challenged because it has resulted in episodes of ruptured appendix, death from ruptured ectopic pregnancies, and serious morbidity from delayed diagnoses of such entities as diverticulitis and endometriosis. Proper diagnostic steps should be taken for all patients with abdominal pain of unclear etiology. This article reviews the pathogenesis of tubo-ovarian abscesses so as to separate and clearly identify fact from fiction. Diagnostic steps and management guidelines are discussed. PMID:3537321

  6. Nocardia brasiliensis vertebral osteomyelitis and epidural abscess.

    PubMed

    Johnson, Philip; Ammar, Hussam

    2013-01-01

    Nocardia species exist in the environment as a saprophyte; it is found worldwide in soil and decaying plant matter. They often infect patients with underlying immune compromise, pulmonary disease or history of trauma or surgery. The diagnosis of nocardiosis can be easily missed as it mimics many other granulomatous and neoplastic disease. We report a 69-year-old man who presented with chronic back pain and paraparesis. He was found to have Nocardial brasiliensis vertebral osteomyelitis and epidural abscess. Laminectomy and epidural wash out was performed but with no neurological recovery. This is the second reported case of N brasiliensis vertebral osteomyelitis in the literature. PMID:23585503

  7. Citrobacter koseri: an unusual cause of pyogenic liver abscess

    PubMed Central

    Gupta, Monica; Sharma, Alka; Singh, Ram; Lehl, S S

    2013-01-01

    Liver abscess is a common pathology in the Indian subcontinent and usually results from amoebic or bacterial infection. Pyogenic abscesses usually occur in those with underlying predisposing factors like intra-abdominal infections, biliary infections or comorbidities like malignancy, immunosuppression, diabetes mellitus and previous biliary surgery or interventional endoscopy. Citrobacter is an unusual cause of pyogenic liver abscess and may occur in the setting of underlying comorbidities. We report a 56-year-old man with diabetes (operated for periampullary carcinoma 20 years ago), who presented with a history of fever for 1 week and on evaluation was found to have Citrobacter koseri-related hepatic abscess. The patient was managed with parenteral antibiotics, repeated aspiration of liver abscess and pigtail drainage. PMID:23505286

  8. A skin abscess model for teaching incision and drainage procedures

    PubMed Central

    Fitch, Michael T; Manthey, David E; McGinnis, Henderson D; Nicks, Bret A; Pariyadath, Manoj

    2008-01-01

    Background Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees to learn and practice this basic physician procedure. Methods We developed a realistic model of skin abscess formation to demonstrate the technique of incision and drainage for educational purposes. The creation of this model is described in detail in this report. Results This model has been successfully used to develop and disseminate a multimedia video production for teaching this medical procedure. Clinical faculty and resident physicians find this model to be a realistic method for demonstrating abscess incision and drainage. Conclusion This manuscript provides a detailed description of our model of abscess incision and drainage for medical education. Clinical educators can incorporate this model into skills labs or demonstrations for teaching this basic procedure. PMID:18598345

  9. Luc’s abscess as an unlucky complication of mastoiditis

    PubMed Central

    Scrafton, DK; Nogueira, C; Mortimore, S

    2014-01-01

    Luc’s abscess is a rare but important complication of acute otitis media (AOM), whereby infection spreads from the middle ear, resulting in a subperiosteal collection beneath the temporal muscle. Unlike other extracranial abscesses relating to AOM, Luc’s abscess is not believed to involve the mastoid bone. We present the case of a patient with a Luc’s abscess with mastoid involvement and discuss its successful management. We believe that patients presenting with a subperiosteal collection beneath the temporal muscle and mastoiditis may represent a different group of patients to those described originally by Luc. These individuals can be differentiated using computed tomography (CT) of the temporal bones. We advocate CT in patients with Luc’s abscess and AOM; this aids preoperative surgical planning. PMID:24992410

  10. Evaluation and management of spinal epidural abscess.

    PubMed

    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. Journal of Hospital Medicine 2016;11:130-135. 2015 Society of Hospital Medicine. PMID:26540492

  11. Colonic abscess induced by India ink tattooing.

    PubMed

    Bang, Chang Seok; Kim, Yeon Soo; Baik, Gwang Ho; Han, Sang Hak

    2014-07-01

    Endoscopic tattooing with India ink is generally regarded as a safe procedure that enables ready identification of endoluminal cancer from the serosal surface. However, significant complications have been reported, including local inflammatory pseudotumor formation, peritonitis, rectus muscle abscess, small bowel infarction, and phlegmonous gastritis. Although the mechanism of complication is not completely understood, it may be related to the chemical compounds contained in the ink solution and enteric or extraenteric bacterial inoculation by injection needle or the ink itself. Authors encountered a case of a 60-year-old man with a resectable sigmoid colon cancer which was tattooed with India ink for subsequent localization in the intraoperative setting. During the laparoscopic operation, the proximal and distal margin of the lesion appeared edematous with bluish color. The distal resection margin was extended approximately 5 cm more than expected because of long extent of edematous mucosa. Histologic examination of the edematous tattooing area revealed an ink abscess spreading laterally above the muscularis propria. Although tattooing is widely used and relatively safe, the presented case indicates the risk of infection or inflammation by tattooing. PMID:25073671

  12. Transurethral Drainage of Prostatic Abscess: Points of Technique

    PubMed Central

    El-Shazly, Mohamed; El- Enzy, Nawaf; El-Enzy, Khaled; Yordanov, Encho; Hathout, Badawy; Allam, Adel

    2012-01-01

    Background The incidence of prostatic abscess (PA) has markedly declined with the widespread use of antibiotics and the decreasing incidence of urethral gonococcal infections. Objectives To evaluate different treatment methods for prostatic abscess and to describe technical points that will improve the outcome of transurethral (TUR) drainage of prostatic abscess. Patients and Methods We performed a retrospective study of a series of 11 patients diagnosed with prostatic abscess, who were admitted and treated in Farwaniya Hospital, Kuwait, between February 2008 and November 2010. Drainage was indicated when antibiotic therapy did not cause clinical improvement and after prostatic abscess was confirmed by TRUS (Transrectal ultrasonography) and/or CT computed Tomographyscan. TUR drainage was indicated in 7 cases, ultrasound-guided transrectal drainage was performed in 2 cases, and ultrasound-guided perineal drainage was performed in 2 cases. Results All patients that underwent TUR-drainage had successful outcomes, without the need of secondary treatment or further surgery. Conclusions TUR drainage of a prostatic abscess increases the likelihood of a successful outcome and lowers the incidence of treatment failure or repeated surgery. Less invasive treatment, with perineal or transrectal aspiration, may be preferred as a primary treatment in relatively young patients with localized abscess cavities. PMID:23573466

  13. Do postoperative antibiotics prevent abscess formation in complicated appendicitis?

    PubMed

    Kimbrell, Ashlee R; Novosel, Timothy J; Collins, Jay N; Weireter, Leonard J; Terzian, Hillman W T; Adams, Ryan T; Beydoun, Hind A

    2014-09-01

    Recent studies have shown that postoperative antibiotics in nonperforated appendicitis do not reduce infectious complications; however, there is no consensus on patients with complicated appendicitis. The aim of this study is to determine whether postoperative antibiotic administration in complicated appendicitis prevents intra-abdominal abscess formation. We conducted a retrospective chart review of all patients undergoing appendectomy from 2007 to 2012 at our institution. Patients with complicated appendicitis (perforated, gangrenous, or periappendiceal abscess) were identified and data collected including details of postoperative antibiotic administration and rates of postoperative abscess development. Of 444 charts reviewed, 52 patients were included. Forty-four patients received greater than 24 hours and eight patients received 24 hours or less of postoperative antibiotics. In those receiving greater than 24 hours of antibiotics, nine of 44 (20.5%) developed a postoperative abscess, and in those receiving 24 hours or less of antibiotics, two of eight (25.0%) developed a postoperative abscess (P = 1.0000). There is no significant difference in postoperative abscess development among those with complicated appendicitis who received greater than 24 hours of postoperative antibiotics compared with those who did not. Postoperative antibiotics may not provide an appreciable clinical benefit for preventing intra-abdominal abscesses; however, larger sample sizes and prospective studies are needed to confirm these findings. PMID:25197874

  14. Splenic abscess: clinical features, microbiologic finding, treatment and outcome.

    PubMed

    Sangchan, Apichat; Mootsikapun, Piroon; Mairiang, Pisaln

    2003-05-01

    Splenic abscess is a rare clinical entity but may be underreported. A retrospective study at Srinagarind Hospital revealed 60 cases of splenic abscess between 1992 and 2001. The causative organisms were identified in 41 cases (68.3%). Gram negative bacilli were commonly isolated and Burkholderia pseudomallei was the most predominant. Diabetes mellitus and leukemia were common underlying diseases found in 46.3 per cent and 9.7 per cent of culture confirmed cases, respectively. The patients usually presented with fever, left upper quadrant pain, tenderness and splenomegaly. Multiple abscesses were more commonly found in the melioidosis than in the non-melioidosis group (p = 0.032), but a single abscess was more commonly found in the non-melioidosis than in the melioidosis group (p = 0.032). Concurrent liver abscesses, often multiple, were not different in both groups. Antimicrobials alone were given in 66.7 per cent of cases with melioidosis and 64.7 per cent of non-melioidosis group. Splenectomy and percutaneous aspiration were performed only in 29.3 per cent and 4.9 per cent of cases with splenic abscess. The overall mortality rate of splenic abscess was only 4.9 per cent in the present series. In conclusion, splenic abscess is not uncommon. Burkholderia pseudomalleli is the most common causative agent found in the present series. Therefore, it should be targeted in the initial empirical antibiotic therapy before the culture results are available especially when multiple lesions in the spleen and concurrent multiple liver abscesses are seen. Prolonged treatment with appropriate antimicrobials alone is usually effective. Splenectomy and/or aspiration may be useful in selected patients. PMID:12859100

  15. Oral microbiota species in acute apical endodontic abscesses

    PubMed Central

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

    2016-01-01

    Background and objectives Acute apical abscesses are serious endodontic diseases resulting from pulpal infection with opportunistic oral microorganisms. The objective of this study was to identify and compare the oral microbiota in patients (N=18) exhibiting acute apical abscesses, originating from the demographic region in Portland, Oregon. The study hypothesis is that abscesses obtained from this demographic region may contain unique microorganisms not identified in specimens from other regions. Design Endodontic abscesses were sampled from patients at the Oregon Health & Science University (OHSU) School of Dentistry. DNA from abscess specimens was subjected to polymerase chain reaction amplification using 16S rRNA gene-specific primers and Cy3-dCTP labeling. Labeled DNA was then applied to microbial microarrays (280 species) generated by the Human Oral Microbial Identification Microarray Laboratory (Forsyth Institute, Cambridge, MA). Results The most prevalent microorganisms, found across multiple abscess specimens, include Fusobacterium nucleatum, Parvimonas micra, Megasphaera species clone CS025, Prevotella multisaccharivorax, Atopobium rimae, and Porphyromonas endodontalis. The most abundant microorganisms, found in highest numbers within individual abscesses, include F. nucleatum, P. micra, Streptococcus Cluster III, Solobacterium moorei, Streptococcus constellatus, and Porphyromonas endodontalis. Strong bacterial associations were identified between Prevotella multisaccharivorax, Acidaminococcaceae species clone DM071, Megasphaera species clone CS025, Actinomyces species clone EP053, and Streptococcus cristatus (all with Spearman coefficients >0.9). Conclusions Cultivable and uncultivable bacterial species have been identified in endodontic abscesses obtained from the Portland, Oregon demographic region, and taxa identifications correlated well with other published studies, with the exception of Treponema and Streptococcus cristae, which were not commonly identified in endodontic abscesses between the demographic region in Portland, Oregon and other regions. PMID:26983837

  16. Neutrophil localization in acute and chronic experimental abscesses

    SciTech Connect

    Bamberger, D.M.; Bettin, K.M.; Gerding, D.N.

    1987-04-01

    Abdominal abscesses are associated with a high mortality, and usually require surgical drainage for cure. A potential mechanism explaining the inability of the host to clear this infection may be in part a result of the inability of the neutrophil to localize at the site of an established infection. To study this question, either acute (4 hours old) or chronic (2 weeks old) abscesses caused by Staphylococcus aureus were created in perforated capsules implanted in the peritoneal cavity of rabbits. Homologous neutrophils were obtained from donor rabbits 4 hours after peritoneal glycogen stimulation and labeled with indium 111 oxine. Only 0.71% of injected /sup 111/In-labeled neutrophils localized in the chronic abscesses, compared with 1.77% in acute abscesses (P less than or equal to 0.01). Animals with chronic infections had a lower intravascular recovery of injected neutrophils (P less than 0.002). Failure of neutrophil localization was not associated with less chemotactic activity within the abscess, as measured by a chemotaxis-under-agarose assay, or caused by a barrier surrounding the abscess as detected by radionuclide imaging. Only 0.07% of injected neutrophils localized into acute abdominal abscesses in animals with a concomitant chronic subcutaneous abscess. These chronically infected animals also demonstrated a low peak intravascular recovery of injected neutrophils when compared with animals with only an acute infection (P less than 0.002). These data reveal that neutrophils localize to abscesses poorly in animals with chronic infections. The mechanism is possibly related to a systemic factor(s) associated with a lower intravascular recovery of injected neutrophils in chronically infected animals.

  17. Pyogenic Intradural Abscess of Lumbar Spine: A Case Report

    PubMed Central

    Cheon, Jeong-Eun; Chung, You-Nam; Park, Sung Bae

    2015-01-01

    We report a case of spinal intradural abscess which shows serial changes on magnetic resonance imaging (MRI). Well-encapsulated, rim-enhancing lesion with mass effect was visualized at ventral side of lumbar spinal canal on 17 days after initial negative MRI, which was thought to be epidural abscess. It was revealed to be intradural in location on operation and successfully treated by drainage and antibiotics. Follow-up MRI showed resolution of abscess. Clinical significance and pathogenesis of this case was briefly discussed. PMID:27169060

  18. Retropharyngeal abscess as a rare presentation of pulmonary tuberculosis.

    PubMed

    Ekka, Meera; Sinha, Sanjeev

    2015-01-01

    A tubercular retropharyngeal abscess is rare in immunocompetent adults. In the case of a tubercular retropharyngeal abscess, it is usually due to cervical spine tuberculosis and is seen mostly in children. A 19-year-old female patient presented to our Medicine Outpatient Department (OPD) at All India Institute of Medical Sciences (AIIMS) with odynophagia and neck pain for two months, without any other constitutional symptoms. On evaluation, she was diagnosed with tubercular retropharyngeal abscess along with pulmonary tuberculosis, without involvement of the cervical spine. This patient was successfully treated by antituberculosis drug therapy alone, without any need for surgical drainage. PMID:25983413

  19. Intraprostatic abscess as a complication of salvage cryotherapy.

    PubMed

    Wu, Ina; Jones, J Stephen

    2010-10-01

    We present a case of prostatic abscess as a previously unreported complication of salvage cryoablation after initial external beam radiotherapy for prostate cancer. An 81-years-old gentleman presented with recurrent urinary tract infection, unresolved after repeated antibiotic treatments, and severe abdominal, back, and perineal pain that developed 2 weeks after undergoing cryotherapy at an outside institution. The patient required open operative drainage of 6 cm prostatic abscess-like cavity noted on computed tomography pelvis and long-term outpatient intravenous antibiotics. This is the first published instance of cryoablation therapy associated with prostatic abscess. PMID:19963256

  20. Iliac osteomyelitis and gluteal muscle abscess caused by Streptococcus intermedius.

    PubMed

    Calza, L; Manfredi, R; Briganti, E; Attard, L; Chiodo, F

    2001-05-01

    Streptococcus intermedius, included in the 'milleri group', is a commensal of the mouth and upper respiratory tract but it has often been associated with various pyogenic infections, such as endocarditis, pneumonia, abdominal or cerebral abscess, rarely with osteomyelitis, and exceptionally with muscular abscess. The first observed case of iliac osteomyelitis with gluteal muscle abscess caused by S. intermedius is reported. It is essential to recognise members of the 'milleri group' as possible agents of bone and muscle pyogenic infection because its management requires a timely diagnosis and prolonged antimicrobial treatment to achieve complete clinical and radiological recovery. PMID:11339259

  1. Splenic Abscesses in a Returning Traveler

    PubMed Central

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

    2015-01-01

    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. PMID:25874071

  2. Amyand's hernia with a periappendicular abscess

    PubMed Central

    Oremule, Babatunde; Ashrafi, Mohammed Hayat

    2014-01-01

    We present a rare case of a perforated vermiform appendix presenting as a strangulated inguinal hernia. An 89-year-old man presented to the surgical assessment unit with a 1-week history of progressively worsening abdominal pain, fever and a tender mass in the right iliac fossa. A diagnosis of strangulated inguinal hernia was made. Intraoperatively, a perforated appendix and a pus-filled sac were found. An appendicectomy and a Bassini repair of the hernia were performed with a satisfactory postoperative outcome. In the majority of cases Amyand's hernia is an intraoperative finding and its management depends on the extent of appediceal disease. In cases of perforated appendix with periappendiceal abscess within the hernial sac, an appedicectomy with Bassini's repair is recommended. PMID:24777080

  3. Cervical epidural abscess caused by brucellosis

    PubMed Central

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

    2012-01-01

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

  4. Salmonella Typhi Vertebral Osteomyelitis and Epidural Abscess

    PubMed Central

    Chua, Ying Ying; Chen, John L. T.

    2016-01-01

    Salmonella vertebral osteomyelitis is an uncommon complication of Salmonella infection. We report a case of a 57-year-old transgender male who presented with lower back pain for a period of one month following a fall. Physical examination only revealed tenderness over the lower back with no neurological deficits. MRI of the thoracic and lumbar spine revealed a spondylodiscitis at T10-T11 and T12-L1 and right posterior epidural collection at the T9-T10 level. He underwent decompression laminectomy with segmental instrumentation and fusion of T8 to L3 vertebrae. Intraoperatively, he was found to have acute-on-chronic osteomyelitis in T10 and T11, epidural abscess, and discitis in T12-L1. Tissue and wound culture grew Salmonella Typhi and with antibiotics susceptibility guidance he was treated with intravenous ceftriaxone for a period of six weeks. He recovered well with no neurological deficits. PMID:27034871

  5. Salmonella Typhi Vertebral Osteomyelitis and Epidural Abscess.

    PubMed

    Khoo, Hau Wei; Chua, Ying Ying; Chen, John L T

    2016-01-01

    Salmonella vertebral osteomyelitis is an uncommon complication of Salmonella infection. We report a case of a 57-year-old transgender male who presented with lower back pain for a period of one month following a fall. Physical examination only revealed tenderness over the lower back with no neurological deficits. MRI of the thoracic and lumbar spine revealed a spondylodiscitis at T10-T11 and T12-L1 and right posterior epidural collection at the T9-T10 level. He underwent decompression laminectomy with segmental instrumentation and fusion of T8 to L3 vertebrae. Intraoperatively, he was found to have acute-on-chronic osteomyelitis in T10 and T11, epidural abscess, and discitis in T12-L1. Tissue and wound culture grew Salmonella Typhi and with antibiotics susceptibility guidance he was treated with intravenous ceftriaxone for a period of six weeks. He recovered well with no neurological deficits. PMID:27034871

  6. Retropharyngeal abscess complicating 'innocent' foreign body ingestion.

    PubMed

    Vourexakis, Zacharias; Konu, Prosper

    2014-01-01

    An adult patient presented to the emergency department with pharyngeal discomfort on swallowing, persisting several hours after lunch. Transnasal fibre-optic endoscopy performed by an otolaryngologist identified a hypopharyngeal foreign body, and the stalk of a dry leaf partially penetrating the mucosa was easily removed under general anaesthesia. Symptoms regressed completely and the patient was discharged. Two days later he presented again, reporting slight dysphagia without odynophagia or other associated symptoms. Meticulous physical examination by the same otolaryngologist revealed this time a slight asymmetry of the posterior pharyngeal wall. A history of recent pharyngeal trauma and findings on clinical examination raised clinical suspicion of retropharyngeal abscess which was supported by CT scan findings. The diagnosis was confirmed in the operating theatre where a purulent collection was drained under new general anaesthesia. PMID:24759165

  7. [Psoas abscess as a chicken pox complication].

    PubMed

    Larcamon, Jorge E; Juanco, Gabriela; Alvarez, Lionel A; Pebe, Florin V

    2010-06-01

    Chicken pox is the most frequent exantematic illness; usually its course is self-limited and benign. Several bacterial complications are described due to the disruption of the skin as a defensive barrier because of the characteristics of the injuries and the associated inmunodepression. Psoas abscess is a rare illness and it's difficult to diagnose, with a general unspecified clinical presentation. We present the case of a 5-year-old girl, on her fifth day of chicken pox, who consults about a febrile convulsion, from which she recovers without any neurological symptoms, referring to functional impotence of her inferior left limb and pain in the lumbar and gluteal zone, which irradiates to the homolateral hip, making deambulation impossible. The definitive diagnosis was made with a CAT at hospital admission. The germ isolated was community-acquired methricillin-resistant Staphilococcus aureus. Treatment consisted in surgical drainage and endovenous antibiotics. PMID:20544129

  8. Peritonsillar abscess: remember to always think twice.

    PubMed

    Windfuhr, Jochen P; Zurawski, Alexandra

    2016-05-01

    Peritonsillar abscess (PTA) is the most common complication of acute tonsillitis resulting in fever, unilateral sore throat, odynophagia and trismus. This retrospective study was undertaken to analyze the clinical courses of 775 patients with two different methods of the first-line treatment. Abscess tonsillectomy (TAC) including contralateral tonsillectomy was preferably performed between 2007 und 2010 (group A; n = 443). After that, incisional drainage (ID) was chosen as first-line treatment between 2010 and 2013 (group B; n = 332). The data of the patients were pooled from the individual charts to evaluate the prevalence of smoking habits, the incidence of the recurrence/complication rates and the number/types of surgical procedures associated with each therapy modality. Replacing TAC by ID as first-line treatment of PTA resulted in a significant decrease of days of inpatient treatment (4 vs. 7 days) and hemorrhage rate (0.3 vs. 5.1 %). A second, third and fourth surgical revision procedure was performed with comparable rates in group A (21.6; 2.4; 0.5 %) and B (21; 4.9; 0.3 %). Smoking habits were reported by almost every second patient. ID as first-line treatment of PTA is capable to reduce the hemorrhage rate and length of inpatient observation significantly. To suggest ID as first-line PTA treatment mandates a close follow-up to indicate repeated drainage of residual pus at an early stage. Further analysis is warranted to verify whether a better surveillance in an academic teaching hospital or surgical modification of the ID is followed by a higher success rate. Smoking habits are overrepresented in PTA patients. PMID:25794541

  9. Abscess of residual lobe after pulmonary resection for lung cancer.

    PubMed

    Ligabue, Tommaso; Voltolini, Luca; Ghiribelli, Claudia; Luzzi, Luca; Rapicetta, Cristian; Gotti, Giuseppe

    2008-04-01

    Abscess of the residual lobe after lobectomy is a rare but potentially lethal complication. Between January 1975 and December 2006, 1,460 patients underwent elective pulmonary lobectomy for non-small-cell lung cancer at our institution. Abscess of the residual lung parenchyma occurred in 5 (0.3%) cases (4 bilobectomies and 1 lobectomy). Postoperative chest radiography showed incomplete expansion and consolidation of residual lung parenchyma. Flexible bronchoscopy revealed persistent bronchial occlusion from purulent secretions and/or bronchial collapse. Computed tomography in 3 patients demonstrated lung abscess foci. Surgical treatment included completion right pneumonectomy in 3 patients and a middle lobectomy in one. Complications after repeat thoracotomy comprised contralateral pneumonia and sepsis in 1 patient. Residual lobar abscess after lobectomy should be suspected in patients presenting with fever, leukocytosis, bronchial obstruction and lung consolidation despite antibiotic therapy, physiotherapy and bronchoscopy. Computed tomography is mandatory for early diagnosis. Surgical resection of the affected lobe is recommended. PMID:18381867

  10. Occult Candida thyroid abscess diagnosed by gallium-67 scanning

    SciTech Connect

    Bach, M.C.; Blattner, S. )

    1990-06-01

    A clinically silent fungal thyroid abscess was identified by Ga-67 citrate scanning and successfully drained surgically in a young leukemic patient. Whole-body radionuclide scanning remains a valuable method to help diagnose persistent fever in the immunocompromised host.

  11. An Easily Overlooked Presentation of Malignant Psoas Abscess: Hip Pain

    PubMed Central

    Askin, Ayhan; Bayram, Korhan Baris; Demirdal, Umit Secil; Korkmaz, Merve Bergin; Gurgan, Alev Demirbilek; Inci, Mehmet Fatih

    2015-01-01

    Psoas abscess is a rare infectious disease with nonspecific clinical presentation that frequently causes a diagnostic difficulty. Its insidious onset and occult characteristics can cause diagnostic delays. It is classified as primary or secondary. Staphylococcus aureus is the most commonly causative pathogen in primary psoas abscess. Secondary psoas abscess usually occurs as a result of underlying diseases. A high index of clinical suspicion, the past and recent history of the patient, and imaging studies can be helpful in diagnosing the disease. The delay of the treatment is related with high morbidity and mortality rates. In this paper, 54-year-old patient with severe hip pain having an abscess in the psoas muscle due to metastatic cervical carcinoma is presented. PMID:25685574

  12. Pulmonary Abscess as a Complication of Transbronchial Lung Cryobiopsy.

    PubMed

    Skalski, Joseph H; Kern, Ryan M; Midthun, David E; Edell, Eric S; Maldonado, Fabien

    2016-01-01

    We present the case of a 49-year-old man who developed pulmonary abscess as a complication of transbronchial lung cryobiopsy. He had been receiving prednisone therapy, but otherwise had no specific risk factors for lung abscess. Cryobiopsy is a novel technique for obtaining peripheral lung parenchymal tissue for the evaluation of diffuse parenchymal lung diseases. Cryobiopsy is being increasingly proposed as an alternative to surgical lung biopsy or conventional bronchoscopic transbronchial forceps biopsy, but the safety profile of the procedure has not been fully appreciated. Pulmonary abscess has been rarely reported as a complication of other bronchoscopic procedures such as endobronchial ultrasound-guided needle biopsy, however, to our knowledge this is the first reported case of pulmonary abscess complicating peripheral lung cryobiopsy. PMID:26705015

  13. Genomewide association study of liver abscess in beef cattle.

    PubMed

    Keele, J W; Kuehn, L A; McDaneld, T G; Tait, R G; Jones, S A; Keel, B N; Snelling, W M

    2016-02-01

    Fourteen percent of U.S. cattle slaughtered in 2011 had liver abscesses, resulting in reduced carcass weight, quality, and value. Liver abscesses can result from a common bacterial cause, , which inhabits rumen lesions caused by acidosis and subsequently escapes into the blood stream, is filtered by the liver, and causes abscesses in the liver. Our aim was to identify SNP associated with liver abscesses in beef cattle. We used lung samples as a DNA source because they have low economic value, they have abundant DNA, and we had unrestricted access to sample them. We collected 2,304 lung samples from a beef processing plant: 1,152 from animals with liver abscess and 1,152 from animals without liver abscess. Lung tissue from pairs of animals, 1 with abscesses and another without, were collected from near one another on the viscera table to ensure that pairs of phenotypically extreme animals came from the same lot. Within each phenotype (abscess or no abscess), cattle were pooled by slaughter sequence into 12 pools of 96 cattle for each phenotype for a total of 24 pools. The pools were constructed by equal volume of frozen lung tissue from each animal. The DNA needed to allelotype each pool was then extracted from pooled lung tissue and the BovineHD Bead Array (777,962 SNP) was run on all 24 pools. Total intensity (TI), an indicator of copy number variants, was the sum of intensities from red and green dyes. Pooling allele frequency (PAF) was red dye intensity divided TI. Total intensity and PAF were weighted by the inverse of their respective genomic covariance matrices computed over all SNP across the genome. A false discovery rate ≤ 5% was achieved for 15 SNP for PAF and 20 SNP for TI. Genes within 50 kbp from significant SNP were in diverse pathways including maintenance of pH homeostasis in the gastrointestinal tract, maintain immune defenses in the liver, migration of leukocytes from the blood into infected tissues, transport of glutamine into the kidney in response to acidosis to facilitate production of bicarbonate to increase pH, aggregate platelets to liver injury to facilitate liver repair, and facilitate axon guidance. Evidence from the 35 detected SNP associations combined with evidence of polygenic variation indicate that there is adequate genetic variation in incidence rate of liver abscesses, which could be exploited to select sires for reduced susceptibility to subacute acidosis and associated liver abscess. PMID:27065119

  14. Persistent root abscess after emergency repair with an aortic homograft.

    PubMed Central

    Ritter, M; von Segesser, L; Jenni, R

    1994-01-01

    A fifty eight year old man with Marfan's syndrome and an aortic composite graft with a Björk-Shiley mechanical prosthesis presented with a large aortic root abscess caused by Staphylococcus aureus endocarditis. Despite extensive surgical debridement and implantation of an aortic homograft as a composite graft, early postoperative transoesophageal echocardiography continued to demonstrate a large aortic root abscess and the patient died in a septic shock. Images PMID:7818972

  15. Suprarenal abscess in the neonate. Technetium-99m glucoheptonate imaging

    SciTech Connect

    Wells, R.G.; Sty, J.R.; Hodgson, N.B.

    1986-01-01

    Although suprarenal abscess in a newborn is rare, a prompt diagnosis is essential for proper patient management. The findings obtained with Tc-99m glucoheptonate renal imaging in a newborn with a right adrenal abscess are reported. A radionuclide renal imaging sequence over a 15-hour period demonstrated a rim sign which can be used to suggest the diagnosis. Radionuclide and ultrasound imaging of neonatal adrenal masses is discussed.

  16. [Epiglottitis with an abscess caused by Haemophilus parainfluenzae.

    PubMed

    Juul, Marie Louise; Johansen, Helle Krogh; Homøe, Preben

    2014-03-17

    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. PMID:25350891

  17. A Tuboovarian Abscess Associated with a Ruptured Spleen

    PubMed Central

    Li, Jennifer S.; Sheele, Johnathan Michael

    2016-01-01

    We report the first case of a tuboovarian abscess complicated by a ruptured spleen. Our patient was a 27-year-old female with human immunodeficiency virus (HIV) who presented to the emergency department (ED) with complaints of urinary symptoms and diarrhea. After being diagnosed with a tuboovarian abscess (TOA), she received antibiotics and was admitted to the gynecology service. Shortly thereafter she developed hemorrhagic shock, necessitating a splenectomy and salpingooophorectomy from a ruptured spleen. PMID:26904315

  18. Ochrobactrum anthropi induced retropharyngeal abscess with mediastinal extension complicating airway obstruction: a case report.

    PubMed

    Al-Naami, Awaji Qasim; Ali Khan, Liaqat; Ali Athlawy, Yahya; Sun, Zhonghua

    2014-06-01

    Retropharyngeal abscess with involvement of mediastinal abscess represents an uncommon complication of upper respiratory tract infections. We report a case presenting with a large retropharyngeal abscess with airway obstruction as the primary presenting symptom. Contrast-enhanced CT showed a large retropharyngeal abscess in the neck with extension to the upper and posterior mediastinal spaces. The abscess was surgically excised with 200 cc pus drained from the neck and mediastinal regions. We describe this case to assist physicians in making the difficult diagnosis when confronting a patient with airway obstruction, as early recognition of retropharyngeal abscess permits emergent airway management. PMID:26229647

  19. Amoebic liver abscess production by Entamoeba dispar.

    PubMed

    Dolabella, Silvio S; Serrano-Luna, Jess; Navarro-Garca, Fernando; Cerritos, Ren; Ximnez, Cecilia; Galvn-Moroyoqui, Jos Manuel; Silva, Edward F; Tsutsumi, Vctor; 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. PMID:22166569

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

    PubMed Central

    Merchant, Chandni; Villanueva, Daphne-Dominique; Lalani, Ishan; Eng, Margaret; Kang, Yong

    2016-01-01

    Staphylococcus schleiferi subsp. schleiferi is a coagulase-negative Staphylococcus which has been described as a pathogen responsible for various nosocomial infections including bacteremia, brain abscess, and infection of intravenous pacemakers. Recently, such bacteria have been described to be found typically on skin and mucosal surfaces. It is also believed to be a part of the preaxillary human flora and more frequently found in men. It is very similar in its pathogenicity with Staphylococcus aureus group and expresses a fibronectin binding protein. Literature on this pathogen reveals that it commonly causes otitis among dogs because of its location in the auditory meatus of canines. Also, it has strong association with pyoderma in dogs. The prime concern with this organism is the antibiotic resistance and relapse even after appropriate treatment. Very rarely, if any, cases have been reported about prostatic abscess (PA) with this microbe. Our patient had a history of recurrent UTIs and subsequent PA resulting in S. schleiferi bacteremia in contrast to gram negative bacteremia commonly associated with UTI. This organism was found to be resistant to methicillin, in spite of being negative for PBP2, which is a rare phenomenon and needs further studies. PMID:27092283

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

    PubMed

    Merchant, Chandni; Villanueva, Daphne-Dominique; Lalani, Ishan; Eng, Margaret; Kang, Yong

    2016-01-01

    Staphylococcus schleiferi subsp. schleiferi is a coagulase-negative Staphylococcus which has been described as a pathogen responsible for various nosocomial infections including bacteremia, brain abscess, and infection of intravenous pacemakers. Recently, such bacteria have been described to be found typically on skin and mucosal surfaces. It is also believed to be a part of the preaxillary human flora and more frequently found in men. It is very similar in its pathogenicity with Staphylococcus aureus group and expresses a fibronectin binding protein. Literature on this pathogen reveals that it commonly causes otitis among dogs because of its location in the auditory meatus of canines. Also, it has strong association with pyoderma in dogs. The prime concern with this organism is the antibiotic resistance and relapse even after appropriate treatment. Very rarely, if any, cases have been reported about prostatic abscess (PA) with this microbe. Our patient had a history of recurrent UTIs and subsequent PA resulting in S. schleiferi bacteremia in contrast to gram negative bacteremia commonly associated with UTI. This organism was found to be resistant to methicillin, in spite of being negative for PBP2, which is a rare phenomenon and needs further studies. PMID:27092283

  2. Intracranial Fusarium Fungal Abscess in an Immunocompetent Patient: Case Report and Review of the Literature

    PubMed Central

    Peterson, Asa; Pham, Martin H.; Lee, Brian; Commins, Deborah; Cadden, Joseph; Giannotta, Steven L.; Zada, Gabriel

    2014-01-01

    Introduction Fusarium spp is an omnipresent fungal species that may lead to fatal infections in immunocompromised populations. Spontaneous intracranial infection by Fusarium spp in immunocompetent individuals is exceedingly rare. Case Report An immunocompetent 33-year-old Hispanic woman presented with persistent headaches and was found to have a contrast-enhancing mass in the left petrous apex and prepontine cistern. She underwent a subsequent craniotomy for biopsy and partial resection that revealed a Fusarium abscess. She had a left transient partial oculomotor palsy following the operation that resolved over the next few weeks. She was treated with long-term intravenous antifungal therapy and remained at her neurologic baseline 18 months following the intervention. Discussion To our knowledge, this is the first reported case of Fusarium spp brain abscess in an immunocompetent patient. Treatment options include surgical intervention and various antifungal medications. Conclusion This case demonstrates the rare potential of intracranial Fusarium infection in the immunocompetent host, as well as its successful treatment with surgical aspiration and antifungal therapy. PMID:25485222

  3. NOTES for the management of an intra-abdominal abscess: transcolonic peritonoscopy and abscess drainage in a canine model

    PubMed Central

    Moustarah, Fady; Talarico, Joseph; Zinc, Jill; Gatmaitan, Patrick; Brethauer, Stacy

    2013-01-01

    Background We studied natural orifice transcolonic drainage of intra-abdominal abscesses in a canine survival model to evaluate the difficulty of peritonoscopy and abscess drainage and the reliability of endoluminal colotomy closure. Methods We placed a 7 cm nonsterile saline-filled latex balloon intra-abdominally to mimic or induce an abscess or inflammatory mass. Seven days later, we advanced a single-channel endoscope transanally into the sigmoid colon of the animal, made a colotomy and then advanced the endoscope intraperitoneally. We evacuated the identified abscess and placed a drain transabdominally. We closed the colotomy endoluminally with a tissue approximation system using 2 polypropylene sutures attached to metal T-bars. Two weeks later, we evaluated the colotomy closure at laparotomy. Results We studied 12 dogs: 8 had subphrenic balloon implants and 4 had inter-bowel loop implants. Eleven survived and underwent transcolonic peritonoscopy; we identified the abscess in 9. The colotomy was successfully closed in 10 of 11 dogs. Although abscesses were easily identified, the overall difficulty of the peritonoscopy was moderate to severe. One dog required colotomy closure via laparotomy, while 9 had successful endoluminal closure. After colotomy closure, 8 animals survived for 2 weeks (study end point) without surgical complications, sepsis or localized abdominal infections. On postmortem examination, all closures were intact without any adjacent organ damage or procedure-related complications. Conclusion Natural orifice transluminal endoscopic surgery provides a novel alternative to treating intra-abdominal pathology. It is technically feasible to perform endoscopic transcolonic peritonoscopy and drainage of an intra-abdominal abscess with reliable closure of the colotomy in a canine experimental model. PMID:23706846

  4. Percutaneous drainage of a diverticular abscess should be limited to two attempts for a resilient diverticular abscess.

    PubMed

    Subhas, Gokulakkrishna; Rana, Gurteshwar; Bhullar, Jasneet; Essad, Kate; Mohey, Leela; Mittal, Vijay K

    2014-07-01

    Management of a resilient diverticular abscess poses a big challenge. Currently there are no guidelines for the number of percutaneous drainages to be performed in resilient diverticular abscesses before attempting surgery. All patients (n = 117) who presented with a computed tomography scan-proven diverticular abscess from July 2008 to June 2011 were studied. They were divided into four groups based on the number of percutaneous drainages they underwent for their diverticular abscess: six patients underwent three or more drainages, nine patients underwent two drainages, 27 patients had one drainage, and 75 patients had no drainage. Readjustment, flushing, and upgrading size of the drain were not considered as separate drainage procedures. The size of abscess cavity was significantly higher for the patients who had three or more drainages (mean 8 cm, P < 0.001). A Hartmann's procedure was performed in the majority of patients in the three or more drainage group (83%) but in decreasing frequency as the number of drainages performed dropped: two drainage group (44%), one drainage group (15%), and no drainage group (19%). There was a significantly higher preoperative hospital stay for drainage and antibiotics in the patients from the three or more drainage group (P < 0.001). Patients with a resilient diverticular abscess are very likely to undergo a Hartmann's procedure after two attempted drainages. By performing additional percutaneous drainages in an attempt to avoid ostomy, patients are at an increased risk of sepsis and peritonitis with prolonged antibiotics and increased healthcare costs. We recommend limiting percutaneous drainage procedures to two attempts to cool down a resilient diverticular abscess before definitive surgery. PMID:24987892

  5. Primary breast lymphoma presenting as non-healing axillary abscess.

    PubMed

    Anele, Chukwuemeka; Phan, Yih Chyn; Wong, Suanne; Poddar, Anil

    2015-01-01

    A 67-year-old woman with non-insulin dependent diabetes mellitus with a history consistent with a right axillary abscess, presented to her general practitioner (GP). A diagnosis of folliculitis was made and the GP started a course of flucloxacillin. Despite antibiotics, the patient's symptoms worsened and the abscess increased in size. This prompted her GP to perform an incision and drainage procedure of the abscess. The practice nurse subsequently oversaw the follow-up care of the wound. Two months after the incision and drainage, and after regular wound dressing, the patient was referred to the acute surgical team with a complicated, non-healing right axillary abscess cavity and associated generalised right breast cellulitis. There was no history of breast symptoms prior to the onset of the axillary abscess. The patient underwent wound debridement, washout and application of negative pressure vacuum therapy. Biopsies revealed primary breast lymphoma (B-cell). She underwent radical chemotherapy and is currently in remission. PMID:26446318

  6. Laparoscopic drainage of liver abscess: case report and literature review

    PubMed Central

    ROMANO, G.; AGRUSA, A.; FRAZZETTA, G.; DE VITA, G.; CHIANETTA, D.; DI BUONO, G.; AMATO, G.; GULOTTA, G.

    2013-01-01

    Summary: Aim. To evaluate the safety and efficacy of the minimally invasive surgical approach (laparoscopic drainage) of liver abscesses in selected cases. Case report. Male, 58 years old, from a rural area, presented with epigastric abdominal pain, fever, weight loss, loss of appetite, a palpable mass in the epigastrium and neutrophilic leukocytosis. CT revealed a complex multiloculated liver abscess in segments 23. Systemic antibiotic therapy alone was ineffective; percutaneous drainage was excluded due to the characteristics of the lesion. Result Given the complexity of the lesion, a laparoscopic approach was chosen involving complete drainage of the abscess, debridement and irrigation; the cavity was unroofed using electrocautery and samples were obtained for bacterial culture and drug testing. Two drains were left in the cavity for seven days. No complications were observed. Discussion. In accordance with the scientific literature, after thorough imaging we performed laparoscopic drainage of a large, complex liver abscess as a safe, effective alternative to open surgery when antibiotic therapy alone failed and percutaneous drainage was uncertain. Conclusion Not all liver abscesses can be treated with antibiotic therapy or percutaneous drainage. Laparoscopic drainage in association with systemic antibiotic therapy is a safe and effective minimally invasive approach that should be considered in selected patients. PMID:23837960

  7. Midline extraperitoneal approach for bilateral widespread retroperitoneal abscess originating from anorectal infection

    PubMed Central

    Okuda, Koji; Oshima, Yuka; Saito, Kentaro; Uesaka, Takahiro; Terasaki, Yasunobu; Kasai, Hironori; Minagawa, Nozomi; Oshima, Takahiro; Okawa, Yumi; Misawa, Kazuhito

    2015-01-01

    Introduction Anorectal abscess is one of the most common anorectal conditions encountered in practice. However, such abscesses may rarely extend upward and cause life-threatening medical conditions. Presentation of case A 53-year-old woman presented with symptoms of anorectal abscess and evidence of severe inflammatory response and acute kidney injury. Computed tomography revealed a widespread abscess extending to the bilateral retroperitoneal spaces. Surgical drainage was performed via a totally extraperitoneal approach through a lower midline abdominal incision, and the patient had a rapid and uncomplicated recovery. Discussion Although retroperitoneal abscesses originating from the anorectal region are rare, they are life-threating events that require immediate treatment. Percutaneous abscess drainage has been recently evolved; however, surgical drainage is required sometimes that may be challenging, particularly in the case of widespread abscesses, as in our case. Conclusion The midline extraperitoneal approach reported here might be an effective surgical option for patients with bilateral widespread retroperitoneal abscesses. PMID:26701843

  8. Case report: perinephric-splenic fistula--a complication of percutaneous perinephric abscess drainage.

    PubMed

    Stewart, I E; Borland, C

    1994-09-01

    A case of acute perinephric abscess due to chronic parenchymal disease and calculi is presented. During percutaneous drainage a reno-splenic vein communication developed acutely. The aetiology and treatment complications of perinephric abscesses are reviewed. PMID:7953232

  9. Gluteal abscess caused by perforating rectal cancer: case report and review of the literature.

    PubMed

    Shimizu, J; Kinoshita, T; Tatsuzawa, Y; Takehara, A; Kawaura, Y; Takahashi, S

    2001-01-01

    An unusual case is described in which an abscess developed remote from a carcinoma of the rectum. A 52-year-old Japanese man developed a gluteal abscess six months after radiation therapy for unresectable carcinoma of the rectum. This case is presented with a review of the literature. Perforating carcinoma of the colon and rectum with abscess formation is best treated by preliminary total diversion colostomy and local drainage of the abscess. However, the mortality rate is still high. PMID:11765183

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

    PubMed Central

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

    2016-01-01

    Pyogenic liver abscesses are caused by various microorganisms and usually present with fever, abdominal pain, leukocytosis and liver enzyme abnormalities. This case presents the insidious manifestation of a pyogenic liver abscess in a 34-year-old immunocompetent male, where classical manifestations of a liver abscess were absent. The microorganisms cultured from the abscess belonged to oral cavity's and gastrointestinal tract's normal flora. PMID:26770811

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

    PubMed

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

    2016-01-01

    Pyogenic liver abscesses are caused by various microorganisms and usually present with fever, abdominal pain, leukocytosis and liver enzyme abnormalities. This case presents the insidious manifestation of a pyogenic liver abscess in a 34-year-old immunocompetent male, where classical manifestations of a liver abscess were absent. The microorganisms cultured from the abscess belonged to oral cavity's and gastrointestinal tract's normal flora. PMID:26770811

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

    PubMed Central

    Yu, Hyeon

    2011-01-01

    Pleural effusion is an accumulation of fluid in the pleural space that is classified as transudate or exudate according to its composition and underlying pathophysiology. Empyema is defined by purulent fluid collection in the pleural space, which is most commonly caused by pneumonia. A lung abscess, on the other hand, is a parenchymal necrosis with confined cavitation that results from a pulmonary infection. Pleural effusion, empyema, and lung abscess are commonly encountered clinical problems that increase mortality. These conditions have traditionally been managed by antibiotics or surgical placement of a large drainage tube. However, as the efficacy of minimally invasive interventional procedures has been well established, image-guided small percutaneous drainage tubes have been considered as the mainstay of treatment for patients with pleural fluid collections or a lung abscess. In this article, the technical aspects of image-guided interventions, indications, expected benefits, and complications are discussed and the published literature is reviewed. PMID:22379278

  13. [Bezold's abscess with wide extension to the lateral skull base].

    PubMed

    Blaser, B; Greusing, B; Häusler, R

    2000-01-01

    The case of a 72-year-old woman suffering from chronic otitis media is presented. This insulin dependent diabetic patient was under steroid therapy for collagenosis and suffered from chronic polysinusitis. After two preceding drainages of the mastoid (antrotomy and mastoidectomy), the patient developed putrid mastoiditis followed by Bezold's abscess, an epidural abscess and thrombosis of the sigmoid sinus. Lateral petrosectomy and drainage of the neck were performed, but the patient again developed an abscess with extension to the lateral skull base, the foramen magnum and the upper cervical spine. After a further operation with extensive drainage and a three-month course of antibiotic treatment with ceftriaxon, the infection finally healed. A germ of the Streptococcus milleri group was identified. PMID:11141932

  14. The penetration of fleroxacin into intra-abdominal abscesses.

    PubMed

    Youngs, D J; Tudor, R G; Yoshioka, K; Keighley, M R

    1988-10-01

    Using a recently developed, low mortality model of an intra-abdominal abscess in the Wistar rat, we have studied the penetration of fleroxacin into the abscess. Maximum serum concentration was 1.83 +/- 0.39 mg l and occurred 1 h after iv injection (20 mg/kg), but even at 4 h after administration the mean serum level was 1.21 +/- 0.27 mg/l. By contrast, levels in pus were 6.27 +/- 0.83 mg/l at 1 h rising steadily to a value of 12.7 +/- 3.69 mg/l at 4 h. The study has confirmed exceptional antibiotic penetration into the abscess, with levels at all time intervals between 0.5 and 8 h after administration in excess of the MIC50 for Escherichia coli, Proteus vulgaris and Clostridium perfringens. PMID:3144528

  15. Endoscopic ultrasound-guided drainage of pelvic collections and abscesses

    PubMed Central

    Fernandez-Urien, Ignacio; Vila, Juan J; Jimenez, Francisco Javier

    2010-01-01

    Pelvic abscesses are usually the end stage in the progression of an infection. They may occur from surgical complications, generalized abdominal infections such as appendicitis or diverticulitis, or from localized infections such as pelvic inflammatory disease or inflammatory bowel disease. Although surgery has been considered as the treatment of choice by some authors, pelvic abscesses can be managed by non-invasive methods such as ultrasound and computed tomography-guided drainage. The development of therapeutic linear echoendoscopes has allowed the endoscopist to perform therapeutic procedures. Recently, endoscopic ultrasonography (EUS)-guided drainage of pelvic collections has been demonstrated to be feasible, efficient and safe. It allows the endoscopist to insert stents and drainage catheters into the abscess cavity which drains through the large bowel. This article reviews technique, current results and future prospects of EUS-guided drainage of pelvic lesions. PMID:21160937

  16. [Case Report of a Splenic Abscess Due to Colon Cancer].

    PubMed

    Suzuki, Katsunori; Akai, Toshiya; Nakamura, Koichi; Higashi, Yukihiro; Shoji, Tsuyoshi; Yamazaki, Masanori; Taniguchi, Masami; Nishiyama, Raisuke; Maruo, Hirotoshi

    2015-11-01

    The patient was a 63-year-old man with a chief complaint of fever and abdominal pain. He was admitted with the diagnosis of splenic abscess on enhanced abdominal computed tomography. After improvement of general condition, we planned a colonoscopy. However, the symptoms were not relieved, so we decided to perform splenectomy. The operative findings included a bulky mass at the splenic flexure, which involved the spleen and the pancreatic tail. Therefore, partial colectomy, splenectomy, and distal pancreatectomy were performed. The pathological examination revealed that the splenic abscess had not developed as a direct extension of the colon cancer but the cancer spread to the splenic hilus. Surgical resection is the first choice in the therapy of splenic abscess developing from colon cancer. PMID:26805319

  17. Pyogenic liver abscess secondary to disseminated streptococcus anginosus from sigmoid diverticulitis.

    PubMed

    Murarka, Shishir; Pranav, Fnu; Dandavate, Varsha

    2011-01-01

    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. PMID:21572613

  18. [Prevertebral abscess and endotracheal intubation in patients with infectious spondylitis of cervical vertebrae].

    PubMed

    Musalatov, Kh A; Kolesov, V V

    1998-01-01

    The course of hypostatic abscess in cervical spondylitis is analyzed, and its clinico-roentgenological manifestations are presented. The differential diagnosis between prevertebral abscess and thyroid tumors is described. The modes of application of endotracheal undulation in patients with cervical spondilitis and prevertebral abscess are suggested. PMID:9511296

  19. Chronic spinal subdural abscess mimicking an intradural-extramedullary tumor.

    PubMed

    Lim, Hyo-Yeol; Choi, Hong-Jun; Kim, Sungjun; Kuh, Sung-Uk

    2013-05-01

    Spinal subdural abscesses (SSA) are very rare disease. The etiologies of SSA are hematogenous spread, iatrogenic contamination, and local extension. Elevated WBC counts, ESR, and C-reactive protein are usually found in laboratory tests. But they are not sensitive indicators of SSA, especially chronic abscesses patient tend to have a less specific characteristic. We report the case of a healthy man with chronic subdural abscess referred to our hospital as an intradural-extramedullary (IDEM) tumor. The patient presented with voiding difficulty and pain in the back and left leg. In a contrast MRI scan, a rim-enhanced mass-like lesion was seen at the L5/S1 level. But adjacent ill-defined epidural fat enhancement that are unusual imaging manifestation for IDEM tumors was seen. He had no fever and normal WBC, ESR, and CRP. In addition, the patient had no previous infection history or other disease, but he did have an epidural block for back pain at another hospital 2 years previously. So, we repeated the MRI with a high-resolution 3-T scanner. The newly taken MR images in our hospital revealed a clear enlargement of lesion size compared to the previous MRI taken 1 week before in other hospital. We suspected a chronic spinal subdural abscess with recent aggravation and immediately performed surgical evacuation. In the surgical field, tensed dura was observed and pus was identified after opening the abscess capsule. Because chronic spinal subdural abscesses are difficult to diagnose, we could differentiate with IDEM tumor exactly and an exact history taking, contrast MRI are required. PMID:23397217

  20. Scrotal Abscess as Initial Presentation of Squamous Cell Carcinoma

    PubMed Central

    Huen, Kathy H.; Nourparvar, Paymon; DeCaro, John J.; Walsh, Mark D.; Issa, Muta M.; Ritenour, Chad W. M.

    2013-01-01

    We report a case of scrotal squamous cell carcinoma in a 67-year-old man that presented as a recurrent nonhealing scrotal abscess. Radical scrotectomy and bilateral simple orchiectomy were performed. A pudendal thigh flap was used for wound closure. To our knowledge, this is the first report of its use after radical surgery for scrotal cancer. The clinical features, staging, and treatment of scrotal squamous cell carcinoma are reviewed. In this report, we highlight the importance of including scrotal cancer in the differential diagnosis when evaluating a scrotal abscess. PMID:24102031

  1. Pilonidal abscess in the breast: a case report

    PubMed Central

    Lahiri, Rashmi; Mullen, Russell; Ashton, Mark A.; Abbott, Nick C.; Pollock, Anne Marie

    2014-01-01

    Pilonidal sinus is a common entity, most often occurring in the natal cleft. Pilonidal sinus with abscess formation has also been described in hairdressers in the interdigital space. We report a case of pilonidal abscess of the breast in a hairdresser, a rarely reported site, which requires awareness on the clinician's part of this occupational risk, for appropriate management and post-surgery advice on prevention. It is particularly important to impart such information to the reporting pathologist who is key to making this histological diagnosis. PMID:24950682

  2. Aortic root abscess resulting from endocarditis: spectrum of angiographic findings

    SciTech Connect

    Miller, S.W.; Dinsmore, R.E.

    1984-11-01

    Abscesses in the aortic root are a serious complication of infective endocarditis and require accurate diagnosis for antibiotic and surgical management. Nineteen cases of endocarditis of a native valve or prosthetic valve and adjacent abscess cavities were identified with angiography. Of 6 patients with endocarditis of a native valve, 5 had bicuspid aortic valves and all had severe aortic regurgitation. Of 13 patients with endocarditis of a prosthetic aortic valve, all had paravalvular regurgitation. Fistulas were detected into the mitral anulus in 8 patients, and into the right ventricle in 3 patients. No complications from the catheterization were recorded during the 48-hour follow-up.

  3. Abdominal foreign body: late presentation as a rectus sheath abscess.

    PubMed

    Noushif, M; Sivaprasad, S; Prashanth, A

    2011-05-01

    Intra-abdominal ingested foreign bodies are usually an incidental finding, typically encountered in mentally challenged patients. We present the case of a 65-year-old mentally sound woman who presented with recurrent abdominal pain and a lump in the hypogastrium. Evaluation revealed a rectus sheath abscess extending to the peritoneum, with a foreign body in situ. On enquiry, the patient revealed that she had accidentally ingested a tailoring needle 17 years ago. This case illustrates an unusual presentation of an ingested foreign body as a rectus sheath abscess after a long duration. PMID:21633760

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

    PubMed

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

    2016-03-01

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

  5. Treatment of Acute Puerperal Mastitis and Breast Abscess

    PubMed Central

    Cantlie, Helene Bertrand

    1988-01-01

    Mastitis is a benign infection of the breast if it is treated early. If two days elapse before treatment is started, it can lead to serious complications such as chronic or recurrent mastitis or breast abscess. Treatment consists in frequent nursing and massaging or stripping the breast to keep it empty of milk or pus, and appropriate antibiotics. Incision and drainage of a breast abscess can be done in the office under local anesthesia, and the drainage continued at home by the mother. PMID:21253250

  6. Pretracheal Abscess Following Two Weeks of Endotracheal Intubation

    PubMed Central

    Neupane, Narayan; Schmidt, M. Frances; Gulati, Neerja; Perwaiz, Muhammad; Hammoudeh, Fadi; Kennedy, Eneh; Zahir, Mehjabin; Enriquez, Danilo; Quist, Joseph

    2011-01-01

    Pretracheal abscess due to endotracheal intubation has not been reported in literature. We present a case of a female patient who was admitted with acute hypercapnic respiratory failure. Patient was initially managed with noninvasive ventilation but eventually was intubated after sustaining a cardiac arrest. She could not be extubated because of poor weaning parameters, so a tracheostomy was planned. During surgery, a pretracheal abscess was found with destruction of the second, third, and fourth tracheal rings and intact posterior tracheal wall. The possible risk factors, mechanism of injury, and preventive strategy of tracheal complication of intubation are discussed. PMID:21451779

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

    PubMed Central

    Jana, Tanima; Machicado, Jorge D.; Davogustto, Giovanni E.; Pan, Jen-Jung

    2014-01-01

    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. PMID:25389507

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

    PubMed Central

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

    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 preoperative computed tomography (CT) scan in all eight patients. All patients who underwent transurethral holmium laser deroofing of a prostatic abscess had successful outcomes, without the need for secondary surgery. Of the eight patients, seven underwent holmium laser enucleation of the prostate (HoLEP) for the removal of residual adenoma. Markedly reduced multiloculated abscess cavities were found in the follow-up CT in all patients. No prostatic abscess recurrence was found. Transient stress urinary incontinence was observed in three patients. The stress urinary incontinence subsided within 3 weeks in two patients and improved with conservative management within 2 months in the remaining patient. Conclusions Transurethral holmium laser deroofing of prostatic abscesses ensures successful drainage of the entire abscess cavity. Because we resolved the predisposing conditions of prostatic abscess, such as bladder outlet obstruction and prostatic calcification, by simultaneously conducting HoLEP, there was no recurrence of the prostatic abscesses after surgery. We recommend our method in patients requiring transurethral drainage. PMID:25685303

  9. Lumbar septic arthritis and psoas abscess due to Aggregatibacter aphrophilus

    PubMed Central

    Bernard, Fanny; Rossi, Pascal; Lagier, Jean Christophe; Craighero, Fabien; Frances, Yves; Granel, Brigitte

    2011-01-01

    Invasive infections due to Aggregatibacter aphrophilus mainly include negative blood culture endocarditis and osteoarticular infections. The authors present herein a rare case of posterior septic arthritis related to A aphrophilus involving lumbar spine with contiguous abscesses of psoas and paravertebral muscles. The infection likely originated from oral cavity. A good outcome was observed after a prolonged and targeted antibiotherapy. PMID:22696632

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

    PubMed Central

    Thirumala, Raghu; 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. PMID:22075586

  11. Pyogenic Liver Abscess Following Acupuncture and Moxibustion Treatment

    PubMed Central

    Choi, Eun Jung; Jeong, Dong Wook; Cho, Young Hye; Lee, Su Jin; Lee, Jeong Gyu; Kim, Yun Jin; Yi, Yu Hyun; Lim, Ji Yong

    2013-01-01

    Acupuncture treatment is generally regarded as a relatively safe procedure. However, most procedures have some complications and acupuncture treatment is no exception. Reported complications of acupuncture treatment were mostly mild or temporary symptoms, but certain severe adverse effects were also observed. We report here for the first time a case of liver abscess following acupuncture and moxibustion treatment. PMID:24106589

  12. [Classical and laparoscopic therapeutic options in surgery for hepatic abscess].

    PubMed

    Ungureanu, F D; Ungurianu, L; Ioachimescu, M; Debreţin, M; Hodrea, R; Pricop, M; Drăgoescu, D; Moldovan, A C

    2005-01-01

    Although lots of modern surgical and imaging techniques have been developed and last generation antibiotics are in use, the difficulties in the diagnosis and treatment of hepatic abscesses are still a rather sombre reality. Our research concerning 14 patients submitted to surgery within the last ten years can be thought of as a record, considering the poor number of cases in the last decades. So, our study also includes the possible clinical or imaging errors, the technical details of the surgery, the attitude towards the abscess cavity and the still obscure etiology in most of the cases. The correlation between the surgical risk and the rest of the hepatic volume, evaluated by computed scanning technique, represents another objective of this paper. In the large or in the multiple disseminated abscesses, the small area of the remaining functional hepatic tissue, was correlated to the postoperative slow or even bad evolution in two cases. The radiological, ultrasound and scanner control showing the reducing or disappearing of the abscess cavity after drainage in all the cases, represent an argument of the correct therapeutic approach. PMID:15957457

  13. Lung abscess-etiology, diagnostic and treatment options.

    PubMed

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Tsirgogianni, Katerina; Tsavlis, Drosos; Kioumis, Ioannis; Kosmidis, Christoforos; Tsakiridis, Kosmas; Mpakas, Andrew; Zarogoulidis, Paul; Zissimopoulos, Athanasios; Baloukas, Dimitris; Kuhajda, Danijela

    2015-08-01

    Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection. It can be caused by aspiration, which may occur during altered consciousness and it usually causes a pus-filled cavity. Moreover, alcoholism is the most common condition predisposing to lung abscesses. Lung abscess is considered primary (60%) when it results from existing lung parenchymal process and is termed secondary when it complicates another process, e.g., vascular emboli or follows rupture of extrapulmonary abscess into lung. There are several imaging techniques which can identify the material inside the thorax such as computerized tomography (CT) scan of the thorax and ultrasound of the thorax. Broad spectrum antibiotic to cover mixed flora is the mainstay of treatment. Pulmonary physiotherapy and postural drainage are also important. Surgical procedures are required in selective patients for drainage or pulmonary resection. In the current review we will present all current information from diagnosis to treatment. PMID:26366400

  14. [Diagnosis and treatment of acute abscesses of the lungs].

    PubMed

    Lamm, Ia E; Abisheva, A B; Kozachenko, N V; Tsaplina, I E

    1988-06-01

    Under study were results of clinical, immunological and bacteriological examinations of 130 patients with acute abscesses of the lungs. The complex treatment included antibacterial therapy taking into account the antibiotic sensitivity of the microflora, correction of disturbances of the protein and water-salt metabolism, desintoxication measures, immunotherapy and sanitation of purulent cavities and the tracheobronchial tree. PMID:3222852

  15. Clinical Characteristics Associated with Antibiotic Treatment Failure for Tuboovarian Abscesses

    PubMed Central

    Farid, Huma; Lau, Trevin C.; Karmon, Anatte E.; Styer, Aaron K.

    2016-01-01

    Objective. Although parenteral antibiotic treatment is a standard approach for tuboovarian abscesses, a significant proportion of patients fail therapy and require interventional radiology (IR) guided drainage. The objective of this study is to assess if specific clinical factors are associated with antibiotic treatment failure. Study Design. Retrospective medical record review of patients hospitalized for tuboovarian abscesses from 2001 through 2012 was performed. Clinical characteristics were compared for patients who underwent successful parenteral antibiotic treatment, failed antibiotic treatment necessitating subsequent IR drainage, initial drainage with concurrent antibiotics, and surgery. Results. One hundred thirteen patients admitted for inpatient treatment were identified. Sixty-one (54%) patients were treated with antibiotics alone. Within this group, 24.6% failed antibiotic treatment and required drainage. Mean white blood cell count (K/μL) (18.7 ± 5.94 versus 13.9 ± 5.12) (p = 0.003), mean maximum diameter of tuboovarian abscess (cm) (6.8 ± 2.9 versus 5.2 ± 2.0) (p = 0.03), and length of stay (days) (9.47 ± 7.43 versus 4.59 ± 2.4) (p = 0.002) were significantly greater for patients who failed antibiotic treatment. Conclusions. Admission white blood cell count greater than 16 K/μL and abscess size greater than 5.18 cm are associated with antibiotic treatment failure. These factors may provide guidance for initial selection of IR guided drainage. PMID:26989337

  16. Clinical Characteristics Associated with Antibiotic Treatment Failure for Tuboovarian Abscesses.

    PubMed

    Farid, Huma; Lau, Trevin C; Karmon, Anatte E; Styer, Aaron K

    2016-01-01

    Objective. Although parenteral antibiotic treatment is a standard approach for tuboovarian abscesses, a significant proportion of patients fail therapy and require interventional radiology (IR) guided drainage. The objective of this study is to assess if specific clinical factors are associated with antibiotic treatment failure. Study Design. Retrospective medical record review of patients hospitalized for tuboovarian abscesses from 2001 through 2012 was performed. Clinical characteristics were compared for patients who underwent successful parenteral antibiotic treatment, failed antibiotic treatment necessitating subsequent IR drainage, initial drainage with concurrent antibiotics, and surgery. Results. One hundred thirteen patients admitted for inpatient treatment were identified. Sixty-one (54%) patients were treated with antibiotics alone. Within this group, 24.6% failed antibiotic treatment and required drainage. Mean white blood cell count (K/μL) (18.7 ± 5.94 versus 13.9 ± 5.12) (p = 0.003), mean maximum diameter of tuboovarian abscess (cm) (6.8 ± 2.9 versus 5.2 ± 2.0) (p = 0.03), and length of stay (days) (9.47 ± 7.43 versus 4.59 ± 2.4) (p = 0.002) were significantly greater for patients who failed antibiotic treatment. Conclusions. Admission white blood cell count greater than 16 K/μL and abscess size greater than 5.18 cm are associated with antibiotic treatment failure. These factors may provide guidance for initial selection of IR guided drainage. PMID:26989337

  17. Case series: Diffusion weighted MRI appearance in prostatic abscess

    PubMed Central

    Singh, Paramjeet; Yadav, Mukesh K; Singh, Shrawan K; Lal, Anupam; Khandelwal, Niranjan

    2011-01-01

    Diffusion: weighted MRI (DWI) is a novel technique that analyzes the diffusion of water molecules in vivo. DWI has been used extensively in the central nervous system. Its use in body imaging is on the rise. In the prostate, it has been used in the evaluation of prostatic carcinoma. We present DWI findings in two patients of prostatic abscess. PMID:21431033

  18. Ischiorectal fossa abscess after pelvic floor injection of botulinum toxin.

    PubMed

    Brueseke, Taylor J; Lane, Felicia L

    2012-03-01

    Botulinum toxin is used to treat pelvic floor tension myalgia; however, its safety profile is poorly understood. We report an ischiorectal fossa abscess after pelvic floor injections of botulinum toxin. Physicians need to be aware of this possible complication, consider alternate injection techniques and antiseptic preparation before injection. PMID:22381609

  19. Eggerthella lenta Bacteremia Complicated by Spondylodiscitis, Psoas Abscess, and Meningitis

    PubMed Central

    Korman, T. M.; Junckerstorff, R. K.

    2014-01-01

    Eggerthella lenta bacteremia is uncommon and generally associated with abdominal sepsis. The organism and its clinical significance have not been well characterized due to historical difficulties with identification. We report a case of severe infection in a paraplegic man complicated by psoas abscess, osteomyelitis, and meningitis and discuss treatment challenges. PMID:24430458

  20. Postoperative testicular abscess with bacteremia due to Actinomyces neuii

    PubMed Central

    Crescencio, Juan Carlos Rico; Koshy, Robin

    2014-01-01

    Bacteremia due to Actinomyces neuii has been reported in the literature 14 times. A. neuii is an endogenous organism that has been cultured in clinical specimens of the genitourinary tract; we are reporting a unique case of A. neuii postoperative testicular abscess with bacteremia which was successfully treated with surgery and a short course of parenteral antimicrobials.

  1. Intrarenal abscesses due to Ureaplasma urealyticum in a transplanted kidney.

    PubMed

    Eilers, Elisabeth; Moter, Annette; Bollmann, Renate; Haffner, Dieter; Querfeld, Uwe

    2007-03-01

    A young woman developed multiple abscesses in her transplanted kidney. Amplification of the 16S rRNA gene with subsequent sequencing revealed Ureaplasma urealyticum as the infectious agent. Microbiological diagnosis and sensitivity testing led to therapy with levofloxacin, resulting in rapid recovery of the patient. PMID:17229853

  2. Upper Cervical Epidural Abscess in Clinical Practice: Diagnosis and Management.

    PubMed

    Al-Hourani, Khalid; Al-Aref, Rami; Mesfin, Addisu

    2016-06-01

    Study Design Narrative review. Objective Upper cervical epidural abscess (UCEA) is a rare surgical emergency. Despite increasing incidence, uncertainty remains as to how it should initially be managed. Risk factors for UCEA include immunocompromised hosts, diabetes mellitus, and intravenous drug use. Our objective is to provide a comprehensive overview of the literature including the history, clinical manifestations, diagnosis, and management of UCEA. Methods Using PubMed, studies published prior to 2015 were analyzed. We used the keywords "Upper cervical epidural abscess," "C1 osteomyelitis," "C2 osteomyelitis," "C1 epidural abscess," "C2 epidural abscess." We excluded cases with tuberculosis. Results The review addresses epidemiology, etiology, imaging, microbiology, and diagnosis of this condition. We also address the nonoperative and operative management options and the relative indications for each as reviewed in the literature. Conclusion A high index of suspicion is required to diagnose this rare condition with magnetic resonance imaging being the imaging modality of choice. There has been a shift toward surgical management of this condition in recent times, with favorable outcomes. PMID:27190742

  3. Mycobacterium chelonae Abscesses Associated with Biomesotherapy, Australia, 2008

    PubMed Central

    Dancer, Craig; Koehler, Ann P.; Hobby, Michaela; Lease, Chris

    2013-01-01

    An outbreak of skin abscesses occurred in Adelaide, Australia, in association with biomesotherapy, an alternative therapy practice. Mycobacterium chelonae was identified in 8 patient and 3 environmental samples. Our findings show M. chelonae infection can be associated with alternative therapies when infection-control breaches occur. Tighter regulations of alternative therapy practices are needed. PMID:23968779

  4. Pyogenic psoas abscess: a rare complication after orthotopic heart transplantation.

    PubMed

    Madden, Brendan P; Datta, Subir; Planche, Timothy

    2002-08-01

    We describe a 57-year-old man who developed a primary psoas abscess after treatment for acute allograft rejection, 5 years after orthotopic heart transplantation. The infective organism was methicillin-resistant Staphylococcus aureus (MRSA), and the patient underwent successful treatment with computed tomography-guided percutaneous drainage combined with teicoplanin and fusidic acid. PMID:12163097

  5. Lung abscess-etiology, diagnostic and treatment options

    PubMed Central

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Tsirgogianni, Katerina; Tsavlis, Drosos; Kioumis, Ioannis; Kosmidis, Christoforos; Tsakiridis, Kosmas; Mpakas, Andrew; Zissimopoulos, Athanasios; Baloukas, Dimitris; Kuhajda, Danijela

    2015-01-01

    Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection. It can be caused by aspiration, which may occur during altered consciousness and it usually causes a pus-filled cavity. Moreover, alcoholism is the most common condition predisposing to lung abscesses. Lung abscess is considered primary (60%) when it results from existing lung parenchymal process and is termed secondary when it complicates another process, e.g., vascular emboli or follows rupture of extrapulmonary abscess into lung. There are several imaging techniques which can identify the material inside the thorax such as computerized tomography (CT) scan of the thorax and ultrasound of the thorax. Broad spectrum antibiotic to cover mixed flora is the mainstay of treatment. Pulmonary physiotherapy and postural drainage are also important. Surgical procedures are required in selective patients for drainage or pulmonary resection. In the current review we will present all current information from diagnosis to treatment. PMID:26366400

  6. Metastatic muscle abscesses complicating infected total hip arthroplasty.

    PubMed

    Balato, Giovanni; Ascione, Tiziana; Mariconda, Massimo; Pagliano, Pasquale

    2016-03-01

    A 73-year-old woman with rheumatoid arthritis presented to our institution with infection of her right total hip arthroplasty. On admission, a draining sinus tract over the hip and a palpable mass in the left lower posterior region of the neck were detected. The contrast CT scan showed a large abscess in the trapezius muscle and multiple abscesses involving muscle of the neck and right shoulder. Intraoperative specimens from the muscle abscess were positive for presumably the same methicillin-resistant Staphylococcus aureus that sustained the prosthetic joint infection. Prolonged intravenous daptomycin led to remission of the muscle abscess and control of the prosthetic joint infection. The patient refused revision total hip arthroplasty and oral cotrimoxazole was prescribed for chronic suppression of the infection. Three years after the primary surgery there was stable remission of the prosthetic joint infection. This rare case demonstrates the severity of prosthetic joint infections sustained by multiresistant bacteria in immunocompromised hosts, which may result in their bacteraemic spread. PMID:27031898

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

    PubMed Central

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

    2013-01-01

    Liver abscesses are infectious, space occupying lesions in the liver, the two most common abscesses being pyogenic and amoebic. A pyogenic liver abscess (PLA) is a rare condition with a reported incidence of 20 per 100 000 hospital admissions in the western population. The right lobe of the liver is the most common site in both types of liver abscess. Clinical presentation is elusive with complaints of fever, right upper quadrant pain in the abdomen and hepatomegaly with or without jaundice. The aetiology of PLA has changed in the past few decades and may be of biliary, portal, arterial or traumatic origin, but many cases are still cryptogenic. The most common organisms causing PLA are Gram-negative aerobes, especially Escherichia coli and Klebsiella pneumoniae. Studies have shown a high degree of antimicrobial susceptibility of isolated organism resulting in an overall lower mortality in PLA. Here, we present a case of PLA caused by multidrug-resistant Citrobacter freundii, which is an unusual organism to be isolated. PMID:23608848

  8. Comparison of indium 111-labeled platelets v leukocytes in a pyogenic abscess

    SciTech Connect

    Wright, T.P.; Sugerman, H.J.; Tatum, J.L.; Hirsch, J.I.; Sharp, D.E.; Qureshi, G.D.

    1985-02-01

    This study sought to determine which blood component, WBCs or platelets, is the more specific indicator of an abscess and where each localizes. An abscess was created using stool in the hind limb of dogs. After 24 hours, one group was given autologous indium 111-labeled platelets and another group was given autologous indium 111-labeled WBCs. Blood, abscess fluid, infected operative control muscle tissue, and nonoperative control muscle tissue were counted for radioactivity 24 hours after administration of the labeled cells. There was significantly less WBC radioactivity in blood and more within abscess fluid compared with platelets. The highest platelet activity occurred in muscle tissue adjacent to the abscess compared with platelet activity in abscess fluid or control muscle tissue. The unwanted high platelet blood background activity and the desirable high concentration of WBC radioactivity within the abscess fluid makes the latter the preferential radionuclide imaging agent.

  9. Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur.

    PubMed Central

    Goh, K. L.; Wong, N. W.; Paramsothy, M.; Nojeg, M.; Somasundaram, K.

    1987-01-01

    We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics. PMID:3658864

  10. Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur.

    PubMed

    Goh, K L; Wong, N W; Paramsothy, M; Nojeg, M; Somasundaram, K

    1987-07-01

    We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics. PMID:3658864

  11. COMMUNITY ACQUIRED METHICILLIN SENSITIVE STAPHYLOCCUS AUREUS CEREBRAL ABSCESS IN A PREVIOUSLY HEALTH GENTLEMAN MIMICKING SIGNS OF CAVERNOUS SINUS THROMBOSIS-A UNIQUE PRESENTATION.

    PubMed

    Aijazi, Ishma; Abdulla, Fadhil M; Ibrahim, Ahmad Elbagir

    2015-01-01

    Central Nervous System (CNS) infections like meningitis and cerebral abscess caused by Staphylococcus aureus are usually seen in patients with neurosurgical interventions or immune compromised patients or patients with cardiac vegetation's. They are extremely rare in healthy patients. We report a case of a 44 year old Indian gentleman who was perfectly healthy with no known co morbidities, which presented with fever, neck stiffness and altered mental status. He had fulminant staph bacteraemia (as evidenced by persistently positive blood cultures) with meningitis and cerebral abscess. Extensive search was made to find the source of infection, but it was inconclusive. Isolated CNS Methicillin Sensitive Staphylococcus aureus (MSSA) infection in an apparently healthy patient is very rare. This gentleman presented with altered mental status, asymmetrical exophthalmos and multiple cranial nerve palsies. This case highlights the challenge of making early diagnoses of a brain abscess; since it has symptomology mimicking cavernous sinus thrombosis .This is due to the involvement of the cerebellopontine angle and extensive brain oedema and oedema of the retro bulbar tissues. PMID:26182790

  12. Amoebic liver abscess in travellers: indication for image-guided puncture?

    PubMed

    Hoenigl, Martin; Valentin, Thomas; Seeber, Katharina; Salzer, Helmut J F; Zollner-Schwetz, Ines; Flick, Holger; Raggam, Reinhard B; Wagner, Jasmin; Grisold, Andrea J; Spreizer, Christopher; Krause, Robert

    2012-11-01

    Although amoebic liver abscess due to Entamoeba histolytica is one of the most common parasitic infections worldwide, invasive disease remains uncommon in industrialized countries. Metronidazole is the standard of care for complicated and uncomplicated invasive amoebiasis. Puncture of amebic liver abscesses is a treatment option primarily for complicated abscesses (localized in left lobe, multiple, and/or pyogenic abscesses). The role of image-guided percutaneous puncture in initially uncomplicated liver abscess formations still remains unanswered. A subset of patients with uncomplicated amoebic liver abscesses, however, fails to respond to conservative treatment alone. We report two cases of amoebic liver abscess formations in Austrian travelers. Two males, aged 67 and 43, presented with fever, chills and fatigue. Four months prior to admission both patients travelled together to Goa, India, for 4 weeks. Computed tomography showed uncomplicated liver abscess formations and serology for E. histolytica was positive in both patients. Therapy with metronidazole 500 mg four times daily was initiated. Computed tomography then showed an increase in size of liver abscess formations in both patients after 13 and 10 days of intravenous metronidazole therapy, respectively. Patient 1 developed pleural effusion and patient 2 additional liver abscess formations. Therefore CT-guided percutaneous therapeutic catheter drainage of liver abscess formations was performed in both patients without complications. Real time PCR of abscess drainage was positive for E. histolytica in both patients. After completion of metronidazole, paromomycin 500 mg three times daily was initiated for seven days for elimination of cysts and both patients were discharged without further complaints. This report highlights that conservative monotherapeutic treatment alone may not be sufficient in some patients with initially uncomplicated E. histolytica liver abscess. Implementation of additional image guided percutaneous puncture may reduce mortality and disease related costs. PMID:23064858

  13. Differentiating lung abscess and empyema: radiography and computed tomography

    SciTech Connect

    Stark, D.D.; Federle, M.P.; Goodman, P.C.; Podrasky, A.E.; Webb, W.R.

    1983-07-01

    Conventional chest radiographs and computed tomographic (CT) scans of 70 inflammatory thoracic lesions in 63 patients were reviewed and scored for diagnostic features. Pathologic confirmation of the final diagnosis was available in 42% (5/12) of lung abscesses and 31% (18/58) of empyemas. CT alone was sufficient to correctly diagnose 100% (70/70) of cases. Diagnostic information not available from conventional chest radiographs was obtained in 47% (33/70) of cases; in an additional 34% of patients, CT more accurately defined the extent of disease. The most reliable CT features for the differential diagnosis of lung abscess and empyema were wall characteristics, pleural separation, and lung compression. Conventional radiographic features such as size, shape, and the angle of the lesion with the chest wall were less helpful, though also best assessed by CT.

  14. Mycotic Abdominal Pseudoaneurysm due to Psoas Abscess after Spinal Fusion.

    PubMed

    Ryu, Dae Woong; Lee, Sam Youn; Lee, Mi Kyung

    2015-12-01

    A 36-year-old man, who had undergone thoracoscopic anterior spinal fusion using the plate system and posterior screw fusion three months previously, presented to our hospital with left flank pain and fever. Computed tomography indicated the presence of a psoas muscle abscess. However, after two days of percutaneous catheter drainage, a mycotic abdominal aortic pseudoaneurysm was detected via computed tomography. We performed in situ revascularization using a prosthetic graft with omental wrapping. Methicillin-resistant Staphylococcus aureus was identified on blood and pus culture, and systemic vancomycin was administered for one month. Although the abscess recurred, it was successfully treated with percutaneous catheter drainage and systemic vancomycin administration for three months, without the need for instrumentation removal. The patient remained asymptomatic throughout two years of follow-up. PMID:26665118

  15. Nonsurgical resolution of caudal mediastinal paraesophageal abscess in a cat

    PubMed Central

    JUNG, Joohyun; CHOI, Mincheol

    2014-01-01

    A one-year-old, castrated male domestic short hair cat was admitted with a history of anorexia, regurgitation and pyrexia for two days. Fever and leukocytosis were identified. There were a large soft tissue density oval mass in the caudal mediastinum on thoracic radiographs, a fluid-filled oval mass in the caudal mediastinum on ultrasonography, and left-sided and ventrally displaced and compressed esophagus on esophagram. On esophageal endoscopy, there were no esophageal abnormalities. CT findings with a fluid filled mass with rim enhancement indicated a caudal mediastinal paraesophageal abscess. The patient was treated with oral antibiotics, because the owner declined percutaneous drainage and surgery. The patient was admitted on emergency with severe respiratory distress; and ruptured abscess and deteriorated pleuropneumonia were suspected. With intensive hospitalization care and additional antibiotic therapy, the patient had full recovery. PMID:25648207

  16. A Case of an Aortic Abscess around the Elephant Trunk.

    PubMed

    Fujii, Takeshiro; Kawasaki, Muneyasu; Katayanagi, Tomoyuki; Okuma, Shinnosuke; Masuhara, Hiroshi; Shiono, Noritsugu; Watanabe, Yoshinori

    2015-12-20

    A 52-year-old male patient with a history of total arch replacement using the elephant trunk technique for acute aortic dissection 4 years before visited our hospital with the chief complaint of persistent fever. Chest computed tomography (CT) suggested prosthetic vascular graft infection, which was treated surgically after chemotherapy. The first surgery consisted of debridement of an abscess around the vascular graft and in the aorta around the elephant trunk, and thoracic descending aorta replacement and vacuum-assisted closure (VAC) in view of the risk of bleeding from the peripheral region of the elephant trunk. One week later, omental filling was performed as the second step. This is a very rare case of aortic abscess around the elephant trunk that could successfully be managed by graft-conserving treatment. PMID:26226888

  17. Lumbar spine osteomyelitis and epidural abscess formation secondary to acupuncture.

    PubMed

    Godhania, Vinesh

    2016-01-01

    A 39-year-old male with no previous medical history presented with abdominal and low back pain. Based on clinical and radiological findings he was diagnosed with L1/L2 osteomyelitis and epidural abscess. Further history taking revealed recent use of acupuncture for treatment of mechanical back pain. The patient was treated conservatively with an extended course of antibiotics, monitored with repeat MRI scans and had a full recovery with no neurological deficit. This is the first reported case of epidural abscess formation and osteomyelitis after acupuncture in the UK. As acupuncture becomes more commonly used in western countries, it is important to be aware of this rare but serious complication. PMID:26976275

  18. Mycotic Abdominal Pseudoaneurysm due to Psoas Abscess after Spinal Fusion

    PubMed Central

    Ryu, Dae Woong; Lee, Sam Youn; Lee, Mi Kyung

    2015-01-01

    A 36-year-old man, who had undergone thoracoscopic anterior spinal fusion using the plate system and posterior screw fusion three months previously, presented to our hospital with left flank pain and fever. Computed tomography indicated the presence of a psoas muscle abscess. However, after two days of percutaneous catheter drainage, a mycotic abdominal aortic pseudoaneurysm was detected via computed tomography. We performed in situ revascularization using a prosthetic graft with omental wrapping. Methicillin-resistant Staphylococcus aureus was identified on blood and pus culture, and systemic vancomycin was administered for one month. Although the abscess recurred, it was successfully treated with percutaneous catheter drainage and systemic vancomycin administration for three months, without the need for instrumentation removal. The patient remained asymptomatic throughout two years of follow-up. PMID:26665118

  19. Treatment of acute abscesses in the casualty department.

    PubMed Central

    Simms, M H; Curran, F; Johnson, R A; Oates, J; Givel, J C; Chabloz, R; ALexander-Williams, J

    1982-01-01

    In the treatment of acute pyogenic soft-tissue abscess incision, curettage, and primary suture was compared with incision and drainage alone in a randomised prospective trial. Operations were performed under antibiotic cover by casualty officers, and patients were reviewed by an independent observer in a septic dressing clinic. Altogether 114 patients were studied, of whom 54 were treated by curettage and primary suture and 60 by simple drainage. The mean healing time was 8.9 days in those treated by primary suture and 7.8 days in those treated by simple drainage (p less than 0.05). Primary healing failed to occur in 19 (35%) of the sutured wounds, but there were no other complications in either group. It is concluded that incision and drainage alone is adequate treatment for acute soft-tissue abscess. PMID:6805714

  20. Splenic abscess associated with infective endocarditis; Case series

    PubMed Central

    Elasfar, Abdelfatah; AlBaradai, Abdulaziz; AlHarfi, Ziyad; Alassal, Mohamed; Ghoneim, Ayman; AlGhofaili, Fahad

    2015-01-01

    Splenic abscess is a well-described but rare complication of infective endocarditis. Rapid diagnosis and treatment are essential as its course can be fatal. We present three case reports that describe the management of splenic abscesses in patients initially diagnosed with infective endocarditis. In all cases, the diagnosis was based on the findings of abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI). In two of the cases, splenectomy was performed before valve surgery; while in the third case, the spleen was removed after cardiac surgery. All three patients recovered fully, with satisfactory follow-up as outpatients. Immediate splenectomy, combined with appropriate antibiotics and valve replacement surgery alongside multi-disciplinary team work could be the treatment of choice in this clinical scenario. PMID:26136636

  1. Splenic abscess associated with infective endocarditis; Case series.

    PubMed

    Elasfar, Abdelfatah; AlBaradai, Abdulaziz; AlHarfi, Ziyad; Alassal, Mohamed; Ghoneim, Ayman; AlGhofaili, Fahad

    2015-07-01

    Splenic abscess is a well-described but rare complication of infective endocarditis. Rapid diagnosis and treatment are essential as its course can be fatal. We present three case reports that describe the management of splenic abscesses in patients initially diagnosed with infective endocarditis. In all cases, the diagnosis was based on the findings of abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI). In two of the cases, splenectomy was performed before valve surgery; while in the third case, the spleen was removed after cardiac surgery. All three patients recovered fully, with satisfactory follow-up as outpatients. Immediate splenectomy, combined with appropriate antibiotics and valve replacement surgery alongside multi-disciplinary team work could be the treatment of choice in this clinical scenario. PMID:26136636

  2. Periodontal bacteria in rabbit mandibular and maxillary abscesses.

    PubMed

    Tyrrell, Kerin L; Citron, Diane M; Jenkins, Jeffrey R; Goldstein, Ellie J C

    2002-03-01

    Despite the high incidence of odontogenic abscesses in pet rabbits, published data on the bacteriology of these infections are lacking, and clinical cultures are often ambiguous, making antibiotic choices difficult. In order to define the bacteriology of these infections, 12 rabbit mandibular and maxillary abscesses were cultured aerobically and anaerobically. All specimens yielded pathogenic bacteria, including Fusobacterium nucleatum, Prevotella heparinolytica, Prevotella spp., Peptostreptococcus micros, Streptococcus milleri group, Actinomyces israelii, and Arcanobacterium haemolyticum. These organisms are consistent with the characterized bacteriology of periodontal disease in human and other mammalian studies. The isolates were tested against 10 antimicrobial agents commonly used to treat rabbits; 100% of the strains tested were susceptible to clindamycin, 96% were susceptible to penicillin and ceftriaxone, 54% were susceptible to ciprofloxacin, and only 7% were susceptible to trimethoprim-sulfamethoxazole. PMID:11880435

  3. Periodontal Bacteria in Rabbit Mandibular and Maxillary Abscesses

    PubMed Central

    Tyrrell, Kerin L.; Citron, Diane M.; Jenkins, Jeffrey R.; Goldstein, Ellie J. C.

    2002-01-01

    Despite the high incidence of odontogenic abscesses in pet rabbits, published data on the bacteriology of these infections are lacking, and clinical cultures are often ambiguous, making antibiotic choices difficult. In order to define the bacteriology of these infections, 12 rabbit mandibular and maxillary abscesses were cultured aerobically and anaerobically. All specimens yielded pathogenic bacteria, including Fusobacterium nucleatum, Prevotella heparinolytica, Prevotella spp., Peptostreptococcus micros, Streptococcus milleri group, Actinomyces israelii, and Arcanobacterium haemolyticum. These organisms are consistent with the characterized bacteriology of periodontal disease in human and other mammalian studies. The isolates were tested against 10 antimicrobial agents commonly used to treat rabbits; 100% of the strains tested were susceptible to clindamycin, 96% were susceptible to penicillin and ceftriaxone, 54% were susceptible to ciprofloxacin, and only 7% were susceptible to trimethoprim-sulfamethoxazole. PMID:11880435

  4. Streptococcal toxic shock syndrome complicating a peritonsillar abscess.

    PubMed

    Aalling, Mathilde; Klug, Tejs Ehlers

    2015-02-01

    A 68-year-old man was admitted to hospital in an acute confusional state with a 2-week history of fever, influenza-like illness and sore throat. He quickly developed coagulation disturbances, hypotension and renal function impairment. Despite broad-spectrum antibiotic therapy, he deteriorated. Group A streptococcus (GAS) was recovered from blood cultures, which gave the diagnosis streptococcal toxic shock syndrome (STSS). A computed tomography scan showed a right-sided peritonsillar abscess (PTA). Acute tonsillectomy was carried out and the patient recovered. STSS complicating PTA has not previously been described in the literature, but GAS is a common pathogen in PTA. Clinicians should be aware that STSS can develop secondary to tonsillar infections and that abscess development should be suspected in STSS patients who do not respond to antibiotic treatment. PMID:25342572

  5. Nonsurgical resolution of caudal mediastinal paraesophageal abscess in a cat.

    PubMed

    Jung, Joohyun; Choi, Mincheol

    2015-04-01

    A one-year-old, castrated male domestic short hair cat was admitted with a history of anorexia, regurgitation and pyrexia for two days. Fever and leukocytosis were identified. There were a large soft tissue density oval mass in the caudal mediastinum on thoracic radiographs, a fluid-filled oval mass in the caudal mediastinum on ultrasonography, and left-sided and ventrally displaced and compressed esophagus on esophagram. On esophageal endoscopy, there were no esophageal abnormalities. CT findings with a fluid filled mass with rim enhancement indicated a caudal mediastinal paraesophageal abscess. The patient was treated with oral antibiotics, because the owner declined percutaneous drainage and surgery. The patient was admitted on emergency with severe respiratory distress; and ruptured abscess and deteriorated pleuropneumonia were suspected. With intensive hospitalization care and additional antibiotic therapy, the patient had full recovery. PMID:25648207

  6. Lumbar spine osteomyelitis and epidural abscess formation secondary to acupuncture

    PubMed Central

    Godhania, Vinesh

    2016-01-01

    A 39-year-old male with no previous medical history presented with abdominal and low back pain. Based on clinical and radiological findings he was diagnosed with L1/L2 osteomyelitis and epidural abscess. Further history taking revealed recent use of acupuncture for treatment of mechanical back pain. The patient was treated conservatively with an extended course of antibiotics, monitored with repeat MRI scans and had a full recovery with no neurological deficit. This is the first reported case of epidural abscess formation and osteomyelitis after acupuncture in the UK. As acupuncture becomes more commonly used in western countries, it is important to be aware of this rare but serious complication. PMID:26976275

  7. Umbilical cord remnant abscess in a yearling colt.

    PubMed

    Collatos, C; Reef, V B; Richardson, D W

    1989-11-01

    An abscess of the external umbilical remnant and umbilical vein remnant was diagnosed in a 16-month-old colt, using ultrasonography. Because of the colt's size, primary closure of the surgical incision after umbilical cord resection was not complete. Vertical mattress stainless steel sutures and stents were used, and healing was by second intention. Intervening gas-filled viscera made it impossible to visualize ultrasonographically the bladder of umbilical artery remnants in a colt of this age. PMID:2684942

  8. [Self-limited thrombotic microangiopathy associated with perianal abscess].

    PubMed

    Campos, B; Gracia, O; Sanjuán, A; Arto, M A; Gutiérrez, J A

    2004-01-01

    A 43-year-old female with Staphyloccocus-induced perianal abscess, was admitted to hospital because of a clinical picture of acute renal failure and thrombotic microangiopathy. Schistocytes, thrombopenia, a negative Coombs test and no detectable plasma haptoglobin were diagnostic for thrombotic microangiopathy. Antibiotics, surgical drainage, plasmapheresis and fresh frozen plasma were given with a favourable evolution. We review the prognostic factors determining recovery of renal function and hematological abnormalities. PMID:15219078

  9. Granulomatosis with Polyangiitis Presenting as a Parotid Gland Abscess

    PubMed Central

    Dias, Blenda; Soares, Daniela; Sampaio, Patrick; Santiago, Mittermayer

    2015-01-01

    Granulomatosis with polyangiitis (GPA) is a small-vessel vasculitis consisting of necrotizing granulomatous lesions in airways and focal necrotizing glomerulonephritis. However, it may affect other sites such as the skin, central nervous system, eyes, heart, gastrointestinal tract, and liver. We describe a rare case of GPA in which the initial manifestation was the involvement of the parotid gland mimicking a pyogenic abscess. PMID:25815014

  10. Lemierre's syndrome due to intratumoral abscess of the uvula.

    PubMed

    Rahhal, Hassan; de Campos, Fernando Peixoto Ferraz; Ferreira, Cristiane Rubia; Felipe-Silva, Aloisio

    2015-01-01

    Lemierre's syndrome (LS), described in detail in 1936, used to be a life-threatening entity until the advent of antibiotics. Tonsillitis or pharyngitis are the main primary infections and oropharyngeal anaerobic flora is the predominant etiology. However, other primary site infections, as well as other microbiological agents have been reported since the first description. Inflammatory symptoms in the neck and marked findings on physical examination predominate the majority of cases. Nonetheless, the authors report the case of a 54-year-old man with a history of dysphagia followed by cough, purulent expectoration, and fever. The bad condition of his dentition was noteworthy. During the diagnostic work-up, an ulcerated lesion in the uvula and a middle lobe pneumonia were disclosed. Streptococcus viridans was isolated from blood culture. On the fifth day of hospitalization, the patient died after a copious episode of hemoptysis. The autopsy findings depicted an abscess within a squamous cell carcinoma of the uvula, pharyngitis with carotid sheath spreading accompanied by pylephlebitis and thrombosis of the internal jugular vein up to the innominate vein, surrounded by an abscess in the mediastinum. Alveolar hemorrhage and pneumonia were also present. We conclude that the ulcerated carcinoma of the uvula housed an abscess, facilitated by the poor oral hygiene, which triggered LS and the descending mediastinitis. Pulmonary involvement was due to the septic embolism from the internal jugular vein. We would like to highlight the uvula abscess as the primary site of infection in this case of LS with S. viridans as the causative agent. PMID:26558242

  11. Calcaneal Osteomyelitis Associated With a Severe Abscess

    PubMed Central

    Memis, Ali; Mutluoglu, Mesut; Öztürk, Sinan; Kara, Kemal; Ay, Hakan

    2016-01-01

    Diabetic foot osteomyelitis (DFO) is a common complication of the diabetic foot and the majority of minor and major amputations are preceded by DFO. The diagnosis and treatment of DFO are both challenging. Early recognition and comprehensive management of diabetic foot infections may obviate DFO, hence the dreadful consequence-resection of the infected bone. Herein, we present the successful management of a patient presenting with DFO and severe abscess formation of the heel.

  12. Multidrug-resistant Nocardia pseudobrasiliensis presenting as multiple muscle abscesses.

    PubMed

    Veerappan Kandasamy, Vimalkumar; Nagabandi, Arun; Horowitz, Edward A; Vivekanandan, Renuga

    2015-01-01

    A 79-year-old Caucasian man presented with multiple leg abscesses due to Nocardia pseudobrasiliensis. He was on chronic steroid therapy for myasthenia gravis. We present the difficulties in diagnosis and treatment of this rare organism. N. pseudobrasiliensis is a new emerging species that was previously thought to belong to the N. brasiliensis species. The distinction between the two species is extremely important given the different antibiotic susceptibility pattern and association of N. pseudobrasiliensis with more invasive and disseminated disease. PMID:25948839

  13. [A case of liver abscesses in a bull].

    PubMed

    Tromp, J F P; Loeb, E; Kuiper, R

    2005-12-15

    During a farm visit a breeding bull was presented with signs of anorexia, somnolence, and loss of condition. These signs were chronic and slowly progressive. Clinical examination revealed an enlarged liver and subsequent ultrasonography revealed multiple abscesses in the liver. This was confirmed during post-mortem examination. Ultrasonography, proved to be of great diagnostic value, especially because it is a quick and non-invasive procedure. PMID:16395959

  14. Multiple Amoebic Liver Abscess As Initial Manifestation in Hiv Sero-Positive Male

    PubMed Central

    2015-01-01

    Amoebic liver abscess is the most frequent extra-intestinal manifestation of Entamoeba histolytica infection. Immunosuppression is known to predispose to amoebic liver abscess. Although amoebic liver abscess is seen more commonly in patients of Human-Immunodeficiency virus (HIV), first presentation of HIV sero-positive patient as multiple liver abscess is quite uncommon.The author reports an unusual case of multiple liver abscesses in an HIV seropositive patient. This middle aged male with history of multiple unprotected sexual encounters presented with spasmodic abdominal pain, fever, diarrhoea and weight loss along with generalised ill-health and painful liver enlargement. HIV-1 serology was found to be reactive. Imaging revealed an enlarged liver with multiple, irregular, hypoechoic foci characteristic of abscesses. Amoebic aetiology was later confirmed by percutaneous aspiration and microscopy. Administration of appropriate chemotherapeutics along with institution of antiretroviral therapy led to both clinical resolution as well as disappearance of lesions. PMID:26266151

  15. Use of indium-111-labeled autologous leukocytes in differentiating pancreatic abscess from pseudocyst

    SciTech Connect

    Bicknell, T.A.; Kohatsu, S.; Goodwin, D.A.

    1981-09-01

    Pancreatic abscess is very difficult to diagnose and the differentiate from pancreatic pseudocyst based on clinical findings, laboratory studies and roentgenographic examinations. Eight patients diagnosed as having a pancreatic mass by ultrasonography or computed tomography also underwent indium-111-labeled autologous leukocyte scanning (10 scans) for suspected intraabdominal sepsis. This scan detects migration of labeled leukocytes into abscesses or areas of inflammation. Four patients had abscess and positive scans, and four patients had pseudocyst and negative scans. There was one false-positive scan in a patient with a recurrent pancreatic mass after drainage of an abscess. Since pancreatic abscess requires prompt drainage, and since it may be preferable to delay drainage of a pseudocyst, the differentiation of these two conditions is important. This test appears very effective in diagnosing pancreatic abscess and differentiating it from a pseudocyst.

  16. Spinal surgery: an unusual case of spinal epidural abscess.

    PubMed

    Vaught, Kevin A

    2009-01-01

    Southeast Missouri Hospital in Cape Girardeau, Missouri, admitted a patient from an outside hospital with back pain and progressive quadriparesis. Imaging revealed an extensive spinal epidural abscess that extended from the craniocervical junction to the sacral spine. Because of the patient's critical condition and the need to minimize the duration of surgery and anesthesia, two surgical teams simultaneously operated on the patient on the day of admission. One team performed a decompressive laminectomy of C1 through C7 and T1 through T6, while the other team performed, through a separate skin incision, a decompressive laminectomy on T11, L2, L3, and L4 as well as partial evacuation of a psoas abscess. The extensive laminectomies were required due to the adherent granulomatous nature of the abscess. Simple irrigation and intraoperative aspiration with suction was ineffective. The patient remained in the hospital for approximately three weeks and was discharged to a long-term acute care facility. Over the next five months her motor function gradually improved and she was discharged to home. Currently, she remains at home, free of significant pain and able to ambulate independently. PMID:19753924

  17. Renal abscesses in childhood: report of two uncommon cases

    PubMed Central

    Cancelinha, Candida; Santos, Lea; Ferreira, Carmen; Gomes, Clara

    2014-01-01

    Renal abscesses are rare conditions in children, but they must be remembered in differential diagnosis of fever and abdominal pain. The authors report two paediatric cases with unusual presentation. Case 1: a 15-year-old girl was admitted following a period of fever, vomiting and left hypochondrium pain which became more localised to the left lower ribs. Blood tests suggested bacterial infection, but urinalysis and culture were negative. Renal CT scan presented features of bilateral pyelonephritis and left renal abscesses, while ultrasound remained normal until the ninth day of disease. Case 2: a 2-year-old girl, with diagnosis of β-thalassemia minor, had intermittent diffuse abdominal pain with 2 weeks of evolution. Renal ultrasonography and CT scan showed a heterogeneous mass compatible with Willms tumour. Intraoperative diagnosis was compatible with renal abscess with isolation of Proteus mirabilis in the fluid. Both responded well to long-term antibiotics and to surgical drainage (in the second case). PMID:24671317

  18. [Endocavitary drainage (Monaldi's technic) in the treatment of pulmonary abscess].

    PubMed

    Vergeret, J; Dabadie, P; Dupon, M; Maurette, P; Taytard, A; Chevais, R

    1983-01-01

    The technique of intracavitary aspiration introduced by Monaldi in 1938 in the treatment of tuberculous cavities and then applied by him in the treatment of lung abscesses was forgotten for nearly 30 years. The advent of antibiotics and their success explain its abandonment. It may take an important place again in the treatment of difficult cases, as a last resort, after failure of properly conducted classical medical treatment. A study of 20 hospitalised patients in an intensive care unit presenting with severe pulmonary abscesses demonstrates this point. After recalling the causes, the therapeutic difficulties and the complications of these abscesses, the authors describe the medications, the method of endocavitary drainage and the technical problems posed by its use in patients often artificially ventilated. The absence of any major dangers inherent in using this technique is also discussed. Finally the short (one month) and long term (20 months) results were analysed. Three deaths occurred during the initial period, although largely explained by associated lesions in these patients. The other 17 patients, of whom 11 were followed up for more than six months, had a satisfactory outcome from the respiratory stand-point. The disappearance of all signs of infection was constantly obtained and in only four patients the bullous cavities persisted. The authors conclude by attesting the efficacy of the technique and its low risk often in the most critically ill patients. PMID:6878847

  19. Neurobrucellosis presenting as an intra-medullary spinal cord abscess

    PubMed Central

    Vajramani, Girish V; Nagmoti, Mahantesh B; Patil, Chidanand S

    2005-01-01

    Background Of the diverse presentation of neurobrucellosis, intra-medullary spinal cord abscess is extremely rare. Only four other cases have been reported so far. We present a case of spinal cord intra-medullary abscess due to Brucella melitensis. Case presentation A forty-year-old female presented with progressive weakness of both lower limb with urinary incontinence of 6 months duration. She was febrile. Neurological examination revealed flaccid areflexic paraplegia with T10 below sensory impairment including perianal region. An intramedullary mass was diagnosed on Magnetic Resonance Image (MRI) scan extending from T12 to L2. At surgery, a large abscess was encountered at the conus medullaris, from which Brucella melitensis was grown on culture. She was started on streptomycin and doxycycline for 1 month, followed by rifampicin and doxycycline for 1 month. At 2-year follow-up, she had recovered only partially and continued to have impaired bladder function. Conclusion Neurobrucellosis, if not treated early, can result in severe neurological morbidity and sequale, which may be irreversible. Hence it is important to consider the possibility of neurobrucellosis in endemic region and treat aggressively. PMID:16168059

  20. Psoas abscess diagnosed at a Northern university hospital.

    PubMed

    Maagaard, Anne; Oktedalen, Olav

    2002-01-01

    Abscess of the psoas muscle is an infrequent diagnosis at hospitals in Northern countries. We report on 16 patients who had this diagnosis during the period 1991-2001. Eight patients were immigrants who had previously been healthy and most of them had experienced symptoms for approximately 1 y. MRI or CT scans revealed spondylodiscitis in 6 of these patients and Mycobacterium tuberculosis was identified as the causative agent. With the exception of 1 patient who was exclusively treated with antituberculous agents, all 8 immigrant patients were successfully treated with antituberculous agents in addition to percutaneous drainage. The other 8 patients were Norwegians, 4 of whom had underlying conditions such as diabetes mellitus or drug abuse. The causative microorganisms were Staphylococcus aureus or Streptococcus spp., with the exception of M. tuberculosis in 1 case. The Norwegian patients had a more acute history of symptoms than the immigrant patients and 2 of them were in a septic condition on admittance. Two of the Norwegians died of serious infection; 5 were successfully treated with percutaneous drainage in addition to antibiotics and 1 was treated exclusively with antibiotic agents. The clinical history and microorganism associated with psoas abscess seemed to depend on whether or not the patient was an immigrant. Owing to increasing immigration, diagnosis of psoas abscess should be taken into account in Northern countries. PMID:12578159

  1. Giant Thyroid Abscess Related to Postpartum Brucella Infection

    PubMed Central

    Akdemir, Zülküf; Karaman, Erbil; Akdeniz, Hüseyin; Alptekin, Cem

    2015-01-01

    Thyroid gland infection, although rare, may be a life threatening disease. Thyroid abscess, arising from acute suppurative thyroiditis (AST), is a rare clinic condition depending on widespread use of antibiotics. Infection may involve one or both lobes and abscess formation may not be apparent until late stage of the progress of illness. Thyroid left lobe is more often affected than the right one. Brucellosis, especially obvious in endemic areas, is a widely seen zoonosis around the world. Although brucella infection can affect many organs through various complications, thyroid gland infection is rare. We aimed to present ultrasonography (USG) and magnetic resonance images (MRI) of a case with an acute thyroiditis which rapidly developed and grew fast on the left half of the neck during the first postpartum month. As far as we know from literature reviewing, our case is the first case report of a thyroid abscess arising from brucella infection which is developed in first postpartum period with images of ultrasonography and MRI. PMID:25861492

  2. Giant thyroid abscess related to postpartum Brucella infection.

    PubMed

    Akdemir, Zülküf; Karaman, Erbil; Akdeniz, Hüseyin; Alptekin, Cem; Arslan, Harun

    2015-01-01

    Thyroid gland infection, although rare, may be a life threatening disease. Thyroid abscess, arising from acute suppurative thyroiditis (AST), is a rare clinic condition depending on widespread use of antibiotics. Infection may involve one or both lobes and abscess formation may not be apparent until late stage of the progress of illness. Thyroid left lobe is more often affected than the right one. Brucellosis, especially obvious in endemic areas, is a widely seen zoonosis around the world. Although brucella infection can affect many organs through various complications, thyroid gland infection is rare. We aimed to present ultrasonography (USG) and magnetic resonance images (MRI) of a case with an acute thyroiditis which rapidly developed and grew fast on the left half of the neck during the first postpartum month. As far as we know from literature reviewing, our case is the first case report of a thyroid abscess arising from brucella infection which is developed in first postpartum period with images of ultrasonography and MRI. PMID:25861492

  3. Intermesenteric appendicular abscess, a diagnostic challenge; case report and review.

    PubMed

    Mateş, I N; Constantinoiu, S

    2014-01-01

    The appendicular origin of an intermesenteric abscess is rarely suspected prior to surgery, due to atypical clinical presentation and poor sensitivity of exploratory methods. A 43-year-old male was admitted for recent pain and mild tenderness in the epigastrium, slight emesis, leucocytosis (C-reactive protein was not determined), with no pathological findings on simple abdominal radiological examination (Rx). Abdominal ultrasound(US) and endoscopy were irrelevant. The abdomen became moderately tender, distended; diffuse enteric gas,slightly impaired bowel movement could be demonstrated by anew Rx. CT (oral contrast) was performed in the 3rd day:edematous infiltration of the mesentery and of a left-flank digestive loop (jejunal, sigmoidian?), small-size fluid collection(with extraluminal air-level) and paretic loops in the proximity, but normal wall-appearance of the caecum and its surrounding fat; the CT result was inconclusive (perforated diverticulosis or malignancy?). Barium enema: normal,including the caecum. Installation of vesperal fever, progressive mid-abdominal pain, tenderness and formation of a mass were the rationale for open mid-line laparotomy, discovering a large intermesenteric abscess, secondary to perforated gangrenous intermesenteric appendicitis. Surgical outcome of appendectomy was normal. A high index of suspicion may be suggested by: atypical clinical presentation (fever; ileus;presence or formation of a tender, periumbilical, mass) and CT findings (abscess; extraluminal air; ileus). PMID:24742426

  4. Disseminated necrotic mediastinitis spread from odontogenic abscess: our experience

    PubMed Central

    Filiaci, Fabio; Riccardi, Emiliano; Mitro, Valeria; Piombino, Pasquale; Rinna, Claudio; Agrillo, Alessandro; Ungari, Claudio

    2015-01-01

    Summary Aims Deep neck infections are rare but potentially fatal complication of pulpal abscess of the teeth. If an infection can progress rapidly from a toothache to a life threatening infection, then it is critical that dentists be able to recognize the danger signs and identify the patients who are at risk. Mediastinitis is a severe inflammatory process involving the connective tissues that fills the intracellular spaces and surrounds the organs in the middle of the chest. This pathology has both an acute and a chronic form and, in most cases, it has an infectious etiology. This study want to expose the experience acquired in the Oral and Maxillo-facial Sciences Department, Policlinico Umberto I, “Sapienza” University of Rome, regarding two clinical cases of disseminated necrotizing mediastinitis starting from an odontogenic abscess. Methods We report two clinical cases of disseminated necrotic mediastinitis with two different medical and surgical approaches. The radiographic and photographic documentation of the patients was collected in the pre-and post-operatively. All patients underwent a CT scan and MRI. Results Mediastinitis can result from a serious odontogenic abscess, and the extent of its inflammation process must be never underestimated. Dental surgeons play a key role as a correct diagnosis can prevent further increasing of the inflammation process. Conclusions A late diagnosis and an inadequate draining represent the major causes of the elevated mortality rate of disseminated necrotizing mediastinitis. PMID:26330907

  5. Cavernosal Abscess due to Streptococcus Anginosus: A Case Report and Comprehensive Review of the Literature

    PubMed Central

    Dugdale, Caitlin M.; Tompkins, Andrew J.; Reece, Rebecca M.; Gardner, Adrian F.

    2013-01-01

    Corpus cavernosum abscesses are uncommon with only 23 prior reports in the literature. Several precipitating factors for cavernosal infections have been described including injection therapy for erectile dysfunction, trauma, and priapism. Common causal organisms include Staphylococcus aureus, Streptococci, and Bacteroides. We report a unique case of a corpus cavernosum abscess due to proctitis with hematological seeding and review the literature on cavernosal abscesses. PMID:24917758

  6. Indium-111 leukocyte scintigraphic detection of myocardial abscess formation in patients with endocarditis

    SciTech Connect

    Cerqueira, M.D.; Jacobson, A.F.

    1989-05-01

    Myocardial abscess formation in patients with bacterial endocarditis in most clinical settings, especially in patients with prosthetic valves, is a primary indicator for surgical valve replacement. We report the detection of myocardial abscesses using /sup 111/In leukocyte scintigraphy in three patients with prosthetic or native valve endocarditis and nondiagnostic echocardiograms. Leukocyte scintigraphy may allow identification of myocardial abscess formation earlier than other imaging modalities.

  7. Comparative imaging in the evaluation of hepatic abscesses in immunocompromised children

    SciTech Connect

    Sty, J.R.; Starshak, R.J.

    1983-01-01

    Three children, two with aplastic anemia and one with chronic granulomatous disease of childhood, were evaluated for hepatic abscess with hepatic scintigraphy (HS), gray-scale sonography (GSS), 67Ga imaging (GA), and computed tomography (CT). Each of the children was found to harbor two abscesses. All were detected with GSS and CT. In the two children imaged with GA, all four abscesses were seen. In two patients imaged twice with HS, 50% of the lesions were missed.

  8. Hepatic Abscesses in Five Outdoor-housed Rhesus Macaques (Macaca mulatta)

    PubMed Central

    Johnson, A.L.; Ducore, R.M.; Colgin, L.M.; Lewis, A.D.

    2014-01-01

    Background Hepatic abscesses are uncommon in nonhuman primates and usually occur as multifocal microabscesses originating from bacteremia. Methods Necropsy, histopathology, and bacterial cultures were performed on five sub-adult to adult female rhesus macaques (Macaca mulatta) that died spontaneously. Results Necropsy findings included cavitating abscesses in the right central liver lobe of all five animals, with intralesional plant material in four animals. Conclusions This is the first report of cavitating hepatic abscesses with intralesional plant material in nonhuman primates. PMID:25041124

  9. Ultrasonography and indium 111 white blood cell scanning for the detection of intraabdominal abscesses

    SciTech Connect

    Carroll, B.; Silverman, P.M.; Goodwin, D.A.; McDougall, I.R.

    1981-07-01

    Ultrasound and indium 111 white blood cell scanning were performed on 163 patients with suspected intraabdominal abscesses. In all but one case, intraabdominal abscesses were correctly identified by one or both tests; conversely, no patient was falsely diagnosed by both tests to have an abscess. Sonography was useful in those patients with focal symptoms, and frequently identified nonabscess causes for fever. White cell scanning was valuable when focal signs were absent, and frequently identified extraabdominal sources of sepsis. The two imaging modalities are complementary and provide a highly accurate and sensitive means of intraabdominal abscess detection.

  10. Epidemiologic determinants of aural abscessation in free-living eastern box turtles (Terrapene carolina) in Virginia.

    PubMed

    Brown, Justin D; Sleeman, Jonathan M; Elvinger, François

    2003-10-01

    Epidemiologic determinants of 46 cases of aural abscessation in free-living eastern box turtles (Terrapene carolina) admitted to the Wildlife Center of Virginia (Virginia, USA) from 1991 to 2000 were evaluated. County human population density, year and season of admission, weight, and sex did not affect the risk for box turtles to develop aural abscessation. Counties with cases of aural abscessation were not randomly distributed, but rather were clustered into two multi-county regions. Geographic location was the only risk factor associated with aural abscessation in box turtles found in this study. Possible etiologies could include chronic infectious disease, malnutrition, or chronic exposure to environmental contamination with organochlorine compounds. PMID:14733291

  11. Ribotyping to compare Fusobacterium necrophorum isolates from bovine liver abscesses, ruminal walls, and ruminal contents.

    PubMed Central

    Narayanan, S; Nagaraja, T G; Okwumabua, O; Staats, J; Chengappa, M M; Oberst, R D

    1997-01-01

    Restriction fragment length polymorphism analysis of rRNA genes was employed to genetically compare Fusobacterium necrophorum subsp. necrophorum and F. necrophorum subsp. funduliforme isolates from multiple abscesses of the same liver and isolates from liver abscesses, the ruminal wall, and ruminal contents from the same animal. Four livers with multiple abscesses and samples of ruminal contents, ruminal walls, and liver abscesses were collected from 11 cattle at slaughter. F. necrophorum was isolated from all liver abscesses, nine ruminal walls, and six ruminal content samples. Chromosomal DNA of the isolates was extracted and single or double digested with restriction endonucleases (EcoRI, EcoRV, SalI, and HaeIII); then restriction fragments were hybridized with a digoxigenin-labeled cDNA probe transcribed from a mixture of 16S and 23S rRNAs from Escherichia coli. EcoRI alone or in combination with EcoRV yielded the most discriminating ribopatterns for comparison. Within the subspecies multiple isolates from the same liver were indistinguishable based on the ribopattern obtained with EcoRI. The hybridization patterns of liver abscess isolates were concordant with those of the corresponding isolates from ruminal walls in eight of nine sets of samples. None of the six ruminal content isolates matched either the liver abscess isolates or the ruminal wall isolates. The genetic similarity between the isolates from liver abscesses and ruminal walls supports the hypothesis that F. necrophorum isolates of liver abscesses originate from the rumen. PMID:9406386

  12. Cervical epidural abscess: rare complication of bacterial endocarditis with streptococcus viridans: a case report.

    PubMed

    Oh, Jae-Sang; Shim, Jai-Joon; Lee, Kyeong-Seok; Doh, Jae-Won

    2015-03-01

    Although many patients with infective endocarditis (IE) complain of joint, muscle, and back pain, infections at these sights are rare. The incidence of spinal abscess in cervical spine complicating endocarditis is very rare. Although the surgical management is the mainstay of treatment, conservative treatment can get success in selected patients. We report a patient with cervical epidural abscess due to Streptococcus viridans endocarditis. Both epidural abscess and IE were managed conservatively with intravenous antibiotics for 8 weeks, with recovery. It is important to remind spinal epidural abscess can occur in those patients with bacterial endocarditis. PMID:25883665

  13. Ribotyping to compare Fusobacterium necrophorum isolates from bovine liver abscesses, ruminal walls, and ruminal contents.

    PubMed

    Narayanan, S; Nagaraja, T G; Okwumabua, O; Staats, J; Chengappa, M M; Oberst, R D

    1997-12-01

    Restriction fragment length polymorphism analysis of rRNA genes was employed to genetically compare Fusobacterium necrophorum subsp. necrophorum and F. necrophorum subsp. funduliforme isolates from multiple abscesses of the same liver and isolates from liver abscesses, the ruminal wall, and ruminal contents from the same animal. Four livers with multiple abscesses and samples of ruminal contents, ruminal walls, and liver abscesses were collected from 11 cattle at slaughter. F. necrophorum was isolated from all liver abscesses, nine ruminal walls, and six ruminal content samples. Chromosomal DNA of the isolates was extracted and single or double digested with restriction endonucleases (EcoRI, EcoRV, SalI, and HaeIII); then restriction fragments were hybridized with a digoxigenin-labeled cDNA probe transcribed from a mixture of 16S and 23S rRNAs from Escherichia coli. EcoRI alone or in combination with EcoRV yielded the most discriminating ribopatterns for comparison. Within the subspecies multiple isolates from the same liver were indistinguishable based on the ribopattern obtained with EcoRI. The hybridization patterns of liver abscess isolates were concordant with those of the corresponding isolates from ruminal walls in eight of nine sets of samples. None of the six ruminal content isolates matched either the liver abscess isolates or the ruminal wall isolates. The genetic similarity between the isolates from liver abscesses and ruminal walls supports the hypothesis that F. necrophorum isolates of liver abscesses originate from the rumen. PMID:9406386

  14. Severity of liver abscesses and efficiency of feed utilization of feedlot cattle.

    PubMed

    Brink, D R; Lowry, S R; Stock, R A; Parrott, J C

    1990-05-01

    Relationships of gain, intake, feed efficiency and severity of liver abscesses were evaluated in 12 experiments involving 566 head of individually fed cattle. Concentrate level in the diets ranged from 64 to 95%. In all experiments, livers were scored as unabscessed (0), one or two small abscesses (A-), two to four small active abscesses (A) or one or more large, active abscesses (A+). Based on homogeneity of variances, nine of the experiments were divided into two groups. In one group (four experiments) the incidence of liver abscesses was 32.1% and no significant (P greater than .25) effects of liver abscess severity score on feedlot performance variables were found. In the second group (five experiments), the incidence of liver abscesses was 77.7%. In the second group, liver abscess severity score affected final live weight (P less than .10), hot carcass weight (P less than .0001), dry matter intake (P less than .10), daily gain based on live weight recorded 24 h prior to slaughter (P less than .10), daily gain based on live weight estimated from hot carcass weight with a 62% dressing percentage (P less than .0001), feed efficiency using final live weight estimated from hot carcass weight (P less than .0001) and dressing percentage (P less than .01). In all cases, performance means for cattle with A+ liver scores were the only ones that differed significantly from those of non-abscessed cattle. PMID:2365638

  15. Sporotrichoid pattern of nerve abscesses in borderline tuberculoid leprosy: A Case Report (sporotrichoid like abscesses in leprosy).

    PubMed

    Garg, G; Thami, G P; Mohan, H

    2014-01-01

    Linear distribution of multiple subcutaneous nodules or ulcers along the course of lymphatics, classically seen in lymphocutaneous sporotrichosis, has been observed in a number of other infections like localized cutaneous leishmaniasis, cutaneous tuberculous and non tuberculous mycobacterial infections, Pasteurella tularensis, Scopulariopsis blochi, Nocardia brasiliensis, yaws and syphilis. A case of borderline tuberculoid leprosy with multiple cutaneous nodules corresponding to resolving nerve abscesses in a sporotrichoid pattern is being reported. PMID:26411249

  16. Hepatic and systemic metabolic responses to aerobic and anaerobic intra-abdominal abscesses in a highly reproducible chronic rat model.

    PubMed

    Nakatani, T; Sato, T; Marzella, L; Hirai, F; Trump, B F; Siegel, J H

    1984-01-01

    A single, uniform abscess was formed in 100% of the animals inoculated with a fecal pellet made of sterile rat feces, agar, and a known number and strain of bacteria. The effects of monoclonal Escherichia coli abscess (83 rats) were compared to those of sterile abscess (34 rats) and sham operation (35 rats without abscess). Bacteroides fragilis was added to the sterile pellet to study the effect of an anaerobic monoclonal abscess (16 rats) or of a biclonal abscess containing both aerobes and anaerobes (32 rats). After inoculation, a peritonitis stage with leucopenia, hypoglycemia, body weight loss, and slight fever was followed by the abscess stage with leucocytosis and a slight hyperglycemia. Mild hepatic energy charge deficiency and hepatic lactic acidosis were observed in sterile abscess rats, and slightly enhanced energy charge was seen in monoclonal E. coli abscess rats. The addition of B. fragilis to the sterile pellet, alone or together with E. coli, produced hepatic energy charge deficiency and hepatic lactic acidosis, which were significantly enhanced compared with the monoclonal E. coli abscess rats. The greatest effect was seen in the biclonal E. coli plus B. fragilis abscess, suggesting that anaerobic or combined aerobe and anaerobe abscesses may produce a greater hepatic injury than an aerobic organism abscess alone. This may account for the apparent synergic interaction between aerobic and anaerobic organisms. PMID:6380793

  17. Unusual Presentation of Recurrent Pyogenic Bilateral Psoas Abscess Causing Bilateral Pulmonary Embolism by Iliac Vein Compression

    PubMed Central

    Ijaz, Mohsin; Sakam, Sailaja; Ashraf, Umair; Marquez, Jose Gomez

    2015-01-01

    Patient: Male, 47 Final Diagnosis: Bilateral psoas abscess • acute lower extremity deep vein thrombosis • bilateral pulmonary embolism Symptoms: Progressive left leg swelling • productive cough with whitish sputum • right flank pain Medication: Antibiotics and anticoagulation Clinical Procedure: CT-guided percutaneous drain placement Specialty: Internal Medicine/Critical Care Objective: Unusual presentation Background: Psoas abscesses are a known cause of back pain, but they have not been reported as a cause of acute lower extremity thromboses and bilateral pulmonary emboli. We report a patient with bilateral psoas abscesses causing extensive pulmonary emboli through compression of the iliac vein. Case Report: A 47-year-old man presented with bilateral leg swelling over 4 weeks. Physical examination revealed a thin male with bilateral leg swelling, extending to the thigh on his left side. He had hemoglobin of 10.5 g/dl, leukocytosis of 16 000/ml, and an elevated D-dimer. A computed tomography (CT) angiogram of his chest showed extensive bilateral pulmonary emboli and infarcts. He remained febrile with vague flank pain, prompting a CT of his abdomen and pelvis that showed large, multiloculated, septated, bilateral psoas abscesses with compression of the left femoral vein by the left psoas abscess and a thrombus distal to the occlusion. Two liters of pus was drained from the left psoas abscess by CT-guidance, and although the Gram staining showed Gram-positive cocci in clusters, cultures from the abscess and blood were negative. A repeat CT showed resolution of the abscesses, and the drain was removed. He was discharged to a nursing home to complete a course of intravenous antibiotics and anticoagulation. Conclusions: Although the infectious complications of psoas abscesses have been described in the literature, the mechanical complications of bilateral psoas abscesses are lacking. It is important to assess for complete resolution of psoas abscesses through follow-up imaging to prevent venous thromboembolic events. PMID:26356406

  18. Two-year study of bovine hepatic abscessation in 10 abattoirs in County Cork, Ireland.

    PubMed

    O'Sullivan, E N

    1999-10-01

    The livers from 6337, 12- to 16-month-old heifers slaughtered in 10 domestic abattoirs over a period of two years were examined; 368 (5.8 per cent) had gross lesions, of which 120 (1.9 per cent) had abscesses, 74 (1.17 per cent) had only scarring, and 44 (0.7 per cent) had telangiectasis (so-called 'sawdust' liver). Of the 120 livers in which abscesses were detected, 53 (44 per cent) had a single large abscess (>4 cm diameter), 44 (36.6 per cent) had a single small abscess (<4 cm), and 23 (19 per cent) had more than two abscesses; in 20 of them (16.6 per cent) the abscesses were resolving, and in 10 (8.3 per cent) the abscesses were ruptured. Forty-three (35.8 per cent) of the livers with abscesses had adhesions to the diaphragm and diaphragmatic lung lobes, three (2.5 per cent) had adhesions to other abdominal organs, 12 (10 per cent) also had scarring and two (1.7 per cent) also had lesions due to liver fluke. There was no significant association between the liver fluke lesions and the abscesses. In 46 (38.3 per cent) of the livers the abscesses were located in the mid-dorsal diaphragmatic or dorsocranial area of the liver; 28 (23.3 per cent) were adjacent to the posterior vena cava and could as a result have caused thromboembolic disease. Clinical signs attributable to the abscesses were observed in only one animal. PMID:10574271

  19. [Liver abscess and infective endocarditis cases caused by Ruminococcus productus].

    PubMed

    Sucu, Nurgün; Köksal, Iftihar; Yilmaz, Gürdal; Aydin, Kemalettin; Caylan, Rahmet; Aktoz Boz, Gönülden

    2006-10-01

    The genus Ruminococcus which are anaerobe Gram positive cocci, previously classified as Peptostreptococcus, may colonize the upper respiratory tract, gastrointestinal tract, vagina and skin of humans and animals. In this report a case of liver abscess and a case of infective endocarditis caused by Ruminoccocus productus, which is very rarely encountered in the clinical practice were presented. The first case was a 32 years old male who was admitted to the hospital in 2002, with the complaints of fever lasting for 20 days and pain while breathing. The abdominal ultrasonography revealed the presence of a liver abscess, and the drainage material from the abscess yielded Ruminococcus productus, identified in BACTEC 9200 (Becton Dickinson, Sparks, Md) anaerobe system. As the isolate was found to be sensitive to penicilin, the empirical gentamicin and ampicillin/sulbactam therapy was continued. The second case was a 25 years old male who was admitted to the hospital in 2005, with the signs of fever lasting for 3-4 months, chills, bone and joint pains. As multiple vegetations were detected in echocardiography, blood cultures were collected and empirical therapy with ceftriaxone and gentamicin was initiated with the preliminary diagnosis of infective endocarditis. Bacteria which were isolated from blood cultures by BACTEC 9200 system have been identified as R. productus. As this strain was also sensitive to penicillin, the empirical therapy was changed to penicilin and gentamicin. These two cases indicated that R. productus should be considered in complicated infections even if it is a rarely isolated species from the clinical samples. PMID:17205698

  20. Biodistribution of long-circulating PEG-liposomes in a murine model of established subcutaneous abscesses.

    PubMed

    Stearne, Lorna E T; Schiffelers, Raymond M; Smouter, Edwin; Bakker-Woudenberg, Irma A J M; Gyssens, Inge C

    2002-03-19

    The biodistribution of long-circulating PEG-liposomes in a subcutaneous mouse model of established mixed infection abscesses was investigated to assess their possible role as drug carriers in the treatment of small, undrainable intra-abdominal abscesses. There was a 10-30-fold greater localisation of (67)Ga-labelled PEG-liposomes in abscesses compared to uninfected normal skin samples. Over 3% of the injected dose (ID) of liposomes was present in the abscesses 24 h after liposome administration in contrast to 0.1% in normal skin sections. The percentage ID present in the liver, spleen and kidneys was 17%, 4% and 2% per organ respectively. Five days after liposome injection, 2% ID could still be recovered from the abscesses. Using colloidal gold-labelled PEG-liposomes, it was shown that there was a 4-fold greater density of liposome clusters in the subcutaneous tissue surrounding the capsule than in the core of the abscesses. The clusters within the abscesses were distributed evenly. We conclude that PEG-liposomes localise to a significant degree at the infection focus in our mouse model and may provide a new approach to the antimicrobial treatment of intra-abdominal abscesses. PMID:11988183

  1. Pathology of aural abscesses in free-living Eastern box turtles (Terrapene carolina carolina).

    PubMed

    Brown, Justin D; Richards, Jean M; Robertson, John; Holladay, Steven; Sleeman, Jonathan M

    2004-10-01

    Aural abscess or abscess of the middle ear is common in free-living Eastern box turtles (Terrapene carolina carolina) of Virginia (USA) and elsewhere. Although its etiology remains unknown, hypovitaminosis A has been suggested on the basis of similar lesions occurring in captive chelonians fed diets that are deficient in vitamin A. This hypothesis was supported by significantly greater body burdens of organochlorine compounds (reported disruptors of vitamin A metabolism) and a nonsignificant trend toward lower serum and hepatic vitamin A levels in free-living box turtles with this lesion. The tympanic epithelium was evaluated in 27 box turtles (10 with aural abscesses and 17 without). Lesions of the tympanic epithelium of box turtles with aural abscesses included hyperplasia, squamous metaplasia, hyperemia, cellular sloughing, granulomatous inflammation, and bacterial infection. These changes were more severe in turtles with aural abscesses than in those without and were more severe in tympanic cavities that had an abscess compared to those without when the lesion was unilateral. Organs from 21 box turtles (10 with aural abscesses and 11 without) from the study population were examined for microscopic lesions, and minimal histopathologic changes were found, none of which were similar to those found in the tympanic epithelium. Histopathologic changes in box turtles with aural abscesses were consistent with a syndrome that may involve hypovitaminosis A. PMID:15650088

  2. [A subcutaneous thoracic abscess due to the aspiration of an ear of grain].

    PubMed

    Murgoci, G

    1992-01-01

    The paper deals with a child aged 9 years, with spastic then productive cough and moderate haemoptysis. X-ray picture shows a condensation process at the bottom of the right hemothorax. A subcutaneous abscess is registered 10 days after hospitalization. At the abscess incision, a wheatear inhaled previously by the child is found out. PMID:1342810

  3. Indium-111 labeled leukocyte images demonstrating a lung abscess with prominent fluid level

    SciTech Connect

    Massie, J.D.; Winer-Muram, H.

    1986-08-01

    In-111 labeled leukocyte images show an abscess cavity with a fluid level on 24-hour upright images. Fluid levels, frequently seen on radiographs, are uncommon on nuclear images. This finding demonstrates rapid migration of labeled leukocytes into purulent abscess fluid.

  4. Tuberculous abscess of the thyroid gland: a report of two cases.

    PubMed

    Kang, Mandeep; Ojili, Vijayanadh; Khandelwal, Niranjan; Bhansali, Anil

    2006-06-01

    Tuberculosis of the thyroid gland is very rare, with an acute abscess formation being the least common form of presentation. We report the sono-graphic features of two cases of tuberculous thyroid abscess that were confirmed via ultrasound-guided fine needle aspiration biopsy. PMID:16673371

  5. Incidental Diagnosis of Appendiceal Abscess by Colonoscopy; A Case Report and Review of the Literature

    PubMed Central

    Niknam, Ramin; Fattahi, Mohammad Reza; Mahmoudi, Laleh

    2015-01-01

    Although complicated acute appendicitis is occasionally observed in general practice, the diagnosis of appendiceal abscess by colonoscopy is unusual. We report a case of appendiceal abscess with spontaneous drainage into the lumen of colon diagnosed during colonoscopy and resolved by the time of surgery. PMID:26106469

  6. Streptobacillus moniliformis as the causative agent in spondylodiscitis and psoas abscess after rooster scratches.

    PubMed

    Dubois, Damien; Robin, Frdric; Bouvier, Damien; Delmas, Julien; Bonnet, Richard; Lesens, Olivier; Hennequin, Claire

    2008-08-01

    We report a case of Streptobacillus moniliformis spondylodiscitis accompanied by a psoas abscess in an 80-year-old man scratched by a rooster. S. moniliformis was identified from abscess fluid by use of 16S rRNA gene sequencing. After 18 weeks of antimicrobial therapy, the clinical condition of the patient improved. PMID:18562588

  7. Percutaneous needle aspiration in uncomplicated amebic liver abscess: a randomized trial.

    PubMed

    Bammigatti, Chanaveerappa; Ramasubramanian, N S; Kadhiravan, Tamilarasu; Das, Ashok Kumar

    2013-01-01

    Amoebic liver abscess develops in less than 1% of patients with amoebaisis and metronidazole is the drug of choice for the treatment of amebic liver abscess. Abscesses of less than 5 cm can be treated with metronidazole alone. However, abscesses of more than 10 cm must undergo ultrasound guided percutaneous needle aspiration along with metronidazole. The role of percutaneous needle aspiration in abscesses of 5 to 10 cm is not clear. Fifty-seven patients with a solitary, right lobe, uncomplicated amoebic liver abscess of 5-10 cm were randomized to receive either metronidazole alone (control group; n = 29) or ultrasound guided percutaneous needle aspiration along with metronidazole (intervention group; n = 28). Although the resolution of pain and fever occurred earlier in the intervention group (27 h and 17 h, respectively) than the control group (48 h and 30 h, respectively), the difference was not statistically significant (P = 0.16 and 0.48, respectively). There were no deaths during the study period and treatment failure, complications (rupture of abscess), days to normalization of leukocytosis and duration of hospitalization were similar in both groups. Ultrasound guided percutaneous needle aspiration along with metronidazole was no better than metronidazole alone in the management of uncomplicated, solitary, right lobe amoebic liver abscess of 5 to 10 cm. PMID:23550199

  8. Liver abscess within the first week of life in a very low birthweight infant.

    PubMed

    Mannan, Khalid; Tadros, Shereen; Patel, Kamini; Aladangady, Narendra

    2009-01-01

    Liver abscess is rare in neonates. The present report concerns a preterm neonate with history of antenatal laser ablation therapy (to prevent twin to twin transfusion syndrome), who developed liver abscesses within a few days of life. Conservative treatment with antibiotics led to the normalisation of inflammatory markers, leaving an echogenic (calcified) area in the liver. PMID:21886660

  9. Endoscopic ultrasound-guided hepatic and perihepatic abscess drainage: an evolving technique

    PubMed Central

    Changela, Kinesh; Lane, Devin; Anand, Sury; Duddempudi, Sushil

    2014-01-01

    Interventional radiology-guided percutaneous drainage of liver abscesses with concomitant use of antibiotics has been the conventional approach for the treatment of liver abscesses. Hepatic abscesses refractory or not amenable to percutaneous drainage have been treated with surgical drainage, either via laparoscopic or open laparotomy techniques. The aim of this review was to evaluate the technical feasibility and efficacy of endoscopic ultrasound (EUS)-guided drainage of liver abscesses. A literature review was performed to identify the studies describing the technique. In this review article we have summarized case series or reports describing EUS-guided liver abscess drainage. The indications, techniques, endoprostheses, limitations and complications reported are discussed. A total of seven cases have been described so far in the literature which included patients with failed conventional treatment modalities. The EUS-guided drainage technique involves puncturing the abscess using endosonography to gain access, passing a guidewire followed by tract dilation and placement of an endoprosthesis for drainage. Studies have reported 100% technical and clinical success rates in selected cases. No complications were reported. EUS-guided drainage of liver abscesses can be a safe and effective alternative approach in the management of liver abscesses in selected patients. PMID:24587822

  10. Partial hepatic resection for treatment of a single liver abscess in a dairy heifer.

    PubMed

    Parker, J E; Gaughan, E M

    1988-01-01

    A single large hepatic abscess in a 10 month old Holstein heifer was treated successfully by partial hepatic resection. No complications or recurrence of clinical signs have developed in the 9 months since the resection. Partial hepatic resection is an effective treatment of solitary bovine liver abscesses that warrants further investigation. PMID:3238880

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

    PubMed Central

    Jain, Deepak; Verma, Kamal; Jain, Promil

    2014-01-01

    Tuberculosis is a common infectious cause of splenic enlargement in developing countries, but tubercular splenic abscesses are a rare presentation, found predominantly in immunocompromised populations. We report a case of tubercular splenic abscesses with isolated splenic vein thrombosis in an immunocompetent person. PMID:25988047

  12. [Multiple abscesses after a cruise along the Latin American coast].

    PubMed

    Reynolds, C; Schofer, N; Zengin, E; Lohse, A W; Faiss, S; Schmiedel, S

    2016-03-01

    We report a case of an extracutaneus involvement of pyoderma gangrenosum. The patient initially presented with multiple sterile abscesses of the skin, heart, prostate, and kidney. Extracutaneus involvement in pyoderma gangrenosum is very rare. Confirmation of the diagnosis was only possible after exclusion of other relevant differential diagnoses. Continuous search for microbes proved negative and after an empiric therapeutic attempt with prednisolone, the patient improved quickly. However, each time we reduced the steroids even in combination with methotrexate or with azathioprine the patient relapsed. Only after therapy with the tumor necrosis factor-α-inhibitor infliximab was permanent remission achieved. PMID:26782091

  13. [Postoperative complications of Bartholin's duct abscess. About two cases].

    PubMed

    Chêne, G; Tardieu, A-S; Nohuz, E; Rabischong, B; Favard, A; Mage, G

    2006-01-01

    Bartholinitis is the most common infectious vulvar disease and develops in approximately 2% of all women. The choice concerning treatment may be uneasy between medical or surgical modalities, and we have to be cautious because of the risk of severe complications associated with the procedure. We report two cases: one case of sepsis and the other one of bacterial cellulitis after Bartholin's duct abscess marsupialization. In the light of epidemiological and bacteriological date referring to Bartholinitis, we recommend a safe and effective management (particularly the use of broad-spectrum antibiotics) that we will describe. PMID:16777462

  14. Cutaneous abscess caused by Corynebacterium lactis in a companion dog.

    PubMed

    Antunes, João Marcelo Azevedo de Paula; Ribeiro, Márcio Garcia; Demoner, Larissa de Castro; Ramos, Juliana Nunes; Baio, Paulo Victor Pereira; Simpson-Louredo, Liliane; Santos, Cíntia Silva; Hirata, Raphael; Ferioli, Raquel Beneton; Romera, Adriana Resmond Cruz; Vieira, Verônica Viana; Mattos-Guaraldi, Ana Luíza

    2015-07-01

    Many new, emerging and re-emerging diseases of humans are caused by pathogens which originate from animals or products of animal origin. Corynebacterium lactis, a recently described species of the genus Corynebacterium, was first isolated from milk of asymptomatic cows. In the present study a cutaneous abscess caused by C. lactis in a dog was recognized by cytologic and histologic examination in addition to 16S rRNA gene analysis of the microorganism. Therefore, C. lactis should be included among other bacterial species recognized as emerging pathogens for companion animals. PMID:25937144

  15. Staphylococcus lugdunensis abscesses complicating molluscum contagiosum in two children.

    PubMed

    Lacour, Marc; Posfay-Barbe, Klara Maria; La Scala, Giorgio Carlo

    2015-01-01

    We report the occurrence of Staphylococcus lugdunensis abscesses in two girls with molluscum contagiosum who both required surgical intervention under general anaesthesia. S. lugdunensis is a coagulase-negative Staphylococcus recently recognized as an emerging human pathogen. Because of its ubiquitous nature and the high prevalence of molluscum contagiosum in children, it is likely that this as yet unreported association may be underestimated, thus raising the question as to whether bacterial culture of superinfected mollusca should be obtained more often. PMID:25557353

  16. The warm sacroiliac joint. A finding in pelvic abscess

    SciTech Connect

    Slavin, J.D. Jr.; Epstein, N.; Negrin, J.A.; Spencer, R.P. )

    1990-09-01

    Two patients with pain referable to the low back and sacroiliac regions had bone scans with similar findings. In each, one sacroiliac joint was warm (uptake on that side was slightly greater than that in the contralateral area). Ga-67 imaging also demonstrated increased uptake in the same locale. Subsequent CT scanning revealed pelvic abscesses adjacent to the affected joints. Asymmetric uptake of bone imaging agent may have been related to hyperemia and heating of the sacroiliac joint. Rapid defervescence with antibiotics and drainage (and no CT evidence of bone involvement) suggested that osteomyelitis was not involved in these cases.

  17. Tattooing: A potential novel risk factor for iliopsoas abscess

    PubMed Central

    Gulati, Sweny; Jain, Ankur; Sattari, Maryam

    2014-01-01

    Iliopsoas abscess (IPA) is an uncommon infection. The clinical presentation is usually insidious. Most patients present with nonspecific symptoms, leading to difficulty in prompt and accurate diagnosis. Delay in diagnosis can lead to complications, such as sepsis and death. Tattooing has become more popular over the recent years and has been associated with tattooing-related and blood-borne infections. We present two related cases of methicillin-resistant Staphylococcus aureus IPA after tattooing and review the epidemiology, etiology, clinical features, and management of IPA. PMID:25232550

  18. Iliopsoas Abscess Possibly due to Klebsiella pneumoniae Infection after Chemoradiotherapy for Hypopharyngeal Cancer

    PubMed Central

    Hyo, Yukiyoshi; Fujisaki, Tomoya; Hyo, Rui; Tanaka, Hiroki; Harada, Tamotsu

    2016-01-01

    Iliopsoas abscess was once an uncommon condition but now occurs somewhat more frequently due to the increasing number of immunocompromised patients, such as those with diabetes. We encountered a case of iliopsoas abscess following chemoradiotherapy for hypopharyngeal cancer. A 60-year-old man was admitted for a sore throat and left neck swelling. Hypopharyngeal cancer was diagnosed, but the patient refused surgery. After two rounds of chemotherapy, febrile neutropenia developed and chest computed tomography (CT) revealed an iliopsoas abscess. The platelet count was low but recovered after administration of antibiotics and could not be explained by puncture of the abscess. CT-guided drainage eventually improved his symptoms. Even for disorders of the head and neck region, iliopsoas abscess should be suspected in immunocompromised patients who develop a fever. CT and magnetic resonance imaging should be performed at an early stage as it is important to determine whether surgical drainage is indicated. PMID:26989543

  19. Gastric subepithelial lesion complicated with abscess: Case report and literature review.

    PubMed

    Kim, Sung Bum; Oh, Myung Jin; Lee, Si Hyung

    2015-05-28

    Gastric abscess is a localized pyogenic inflammation of the gastric wall, which is a rare form of suppurative gastritis. The rarity of gastric abscess may be associated with the difficulty of early diagnosis and high mortality as a result. In general, subepithelial lesions (SELs) of the stomach are incidentally detected during the course of upper endoscopy without specific clinical symptoms and signs. However, some gastric SELs present rarely as a form of hemorrhage, obstruction, perforation, and abscess. Here we report a 45-year-old man with gastric SEL presenting as a gastric abscess, which was diagnosed as an ectopic pancreas of the stomach, along with a review of the literature. Although gastric SEL presenting as an abscess is known as a serious and life-threatening lesion, the patient made a complete recovery through surgical resection as well as medical treatment. PMID:26034377

  20. Gastric subepithelial lesion complicated with abscess: Case report and literature review

    PubMed Central

    Kim, Sung Bum; Oh, Myung Jin; Lee, Si Hyung

    2015-01-01

    Gastric abscess is a localized pyogenic inflammation of the gastric wall, which is a rare form of suppurative gastritis. The rarity of gastric abscess may be associated with the difficulty of early diagnosis and high mortality as a result. In general, subepithelial lesions (SELs) of the stomach are incidentally detected during the course of upper endoscopy without specific clinical symptoms and signs. However, some gastric SELs present rarely as a form of hemorrhage, obstruction, perforation, and abscess. Here we report a 45-year-old man with gastric SEL presenting as a gastric abscess, which was diagnosed as an ectopic pancreas of the stomach, along with a review of the literature. Although gastric SEL presenting as an abscess is known as a serious and life-threatening lesion, the patient made a complete recovery through surgical resection as well as medical treatment. PMID:26034377

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

    PubMed Central

    Goyal, Ankur; Madhusudhan, Kumble S; Gamanagatti, Shivanand; Baruah, Bhaskar; Shalimar; Sharma, Raju

    2016-01-01

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

  2. Extensive aortic valve ring abscess formation: a rare complication of Q fever endocarditis.

    PubMed Central

    Fort, S.; Fraser, A. G.; Fox, K. A.

    1989-01-01

    We report the successful management and 2 year follow up of a young patient with Q fever endocarditis on a congenitally bicuspid aortic valve complicated by extensive abscess formation in the aortic valve ring and interventricular septum. Aortic root abscess formation complicating Q fever endocarditis has been reported in only one previous patient. Serological tests may thus be indicated in patients with aortic abscesses. Despite extensive aortic and intramyocardial abscess formation it proved possible to control the progression of disease by open drainage of the abscess and aortic valve replacement. Although the requirement for aortic root replacement was anticipated in this patient, it has not been required. Images Figure 1 Figure 2 PMID:2608579

  3. Nasalseptal hematoma/abscess: management and outcome in a tertiary hospital of a developing country

    PubMed Central

    Nwosu, Jones N; Nnadede, Peter C

    2015-01-01

    Background Nasal hematoma/abscess is an uncommon entity, but capable of leading to serious consequences if not handled meticulously, and with urgency. Objective To present the management, and outcome of nasal septal hematoma/abscess in a Nigerian tertiary institution. Method Consecutive patients diagnosed with nasal septal hematoma/abscess over a 10-year period, treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria, were prospectively studied. The processes leading to diagnosis, treatment, and outcome were sequentially evaluated. Results Fifty-three patients (37 males and 16 females), age 5–65 years (with mean age of 23.10 years), were included. Surgical drainage of the hematoma/abscess, intranasal packing with insertion of drain was performed with total resolution of problem in all the cases. Conclusion Incision and drainage, and intranasal packing with insertion of drain was effective in treating nasal septal hematoma/abscess. PMID:26251577

  4. Hepatic abscess caused by Fusobacterium necrophorum after a trip to the dentist.

    PubMed

    Bytyci, Faton; Khromenko, Elena

    2016-01-01

    A 57-year-old man with no significant medical history was admitted to the hospital, with high-grade fever and right upper quadrant pain. He was found, on abdominal ultrasound, to have a right lobe hepatic cystic lesion. MRI of the abdomen confirmed a hepatic abscess. Cultures obtained under CT guidance showed the abscess to be caused by Fusobacterium necrophorum. This is a rare bacterium that can cause potentially fatal liver abscesses. Following drainage and intravenous antibiotic treatment, the patient improved and was discharged on a 4-week antibiotic course. An abdominal CT, performed 6 weeks after discharge, showed total resolution of the abscess. The patient had, 2 weeks prior to the development of the liver abscess, undergone routine dental cleaning. Neither upper respiratory symptoms nor sore throat had been identified prior to the presentation. PMID:26933183

  5. Hepatic ultrasonography and blood changes in cattle with experimentally induced hepatic abscesses.

    PubMed

    Lechtenberg, K F; Nagaraja, T G

    1991-06-01

    Hepatic abscesses were induced experimentally in 5 steers by inoculating Fusobacterium necrophorum via ultrasonography-guided, percutaneous catheterization of the portal vein. Hepatic ultrasonography was performed to determine the onset and progression of abscessation. Blood samples were collected before and after inoculation for performing leukocyte counts and hepatic function tests. Ultrasonographic evidence of liver abscesses was observed as early as 3 days after inoculation. Abscesses appeared as hyperechoic centers (cellular debris and pus) surrounded by hypoechoic or anechoic areas (fluid). Increases in rectal temperature, leukocyte counts, fibrinogen, globulin, bilirubin, gamma-glutamyltransferase, and sorbitol dehydrogenase concentrations were detected. Hepatic dysfunction was evidenced by decrease in serum albumin concentration and low sulfobromophthalein clearance. The ultrasonographic diagnosis of abscesses correlated well with necropsy findings. PMID:1679304

  6. Immunohistochemical and pathological study of Mycoplasma bovis-associated lung abscesses in calves.

    PubMed

    Adegboye, D S; Hallbur, P G; Cavanaugh, D L; Werdin, R E; Chase, C C; Miskimins, D W; Rosenbusch, R F

    1995-07-01

    Out of 45 cases of fatal chronic pneumonia in calves examined for Mycoplasma bovis infection from February to July 1994, 11 cases with pulmonary abscesses that were culture positive for M. bovis were encountered. The cases were studied in detail using a recently developed monoclonal antibody-based immunoperoxidase technique. Mycoplasma bovis organisms were detected in specific locations at all stages of abscessation observed. In bronchioles or terminal airways within which abscesses developed, M. bovis was located at the epithelial surface and in close association with infiltrating neutrophils and macrophages. Abscessed airways that had lost the epithelium were encapsulated and were seen as coagulative necrotic foci that stained intensely for M. bovis, especially at the periphery. Some foci stained weakly and such might have been resolving lesions. Mycoplasma bovis was also demonstrated at sites of mild mononuclear cell infiltration in the livers and kidneys of 2 calves. The mycoplasma was detected within bile ducts in the liver and in the tubular epithelium of the kidney. Abscesses not staining for M. bovis, presumably caused by other pathogens, were seen concurrently with M. bovis-associated abscesses in some lungs. Thirteen other M. bovis-positive cases showed no abscesses, possibly indicating heterogeneity among M. bovis strains. Three other cases with abscesses were negative for M. bovis by culture and immunoperoxidase staining. The monoclonal antibody-based immunohistochemical technique is efficient for specific detection of M. bovis in cases of enzootic pneumonia of calves with or without abscessation. Mycoplasma bovis is implicated in the pathogenesis of lung abscesses in some calves. PMID:7578447

  7. Retropharyngeal Abscess Initially Diagnosed by the Videofluoroscopic Swallowing Study

    PubMed Central

    Leigh, Ja-ho

    2012-01-01

    In this article, we report a case where a videofluoroscopic swallowing study (VFSS) revealed the cause of a recently developed idiopathic dysphagia in a 66-year-old patient and enabled emergent treatment. The patient reported a 10-day history of fever, cough, sputum production, and progressive jaundice. He was then admitted to the hospital with suspicion of aspiration pneumonia. Despite treatment with antibiotics, fever and leukocytosis were persistent. As he also reported dysphagia, we performed the VFSS, which showed subglottic aspiration on all types of food and revealed a retropharyngeal mass causing mechanical compression. A contrast-enhanced computerized tomography (CT) of his neck was performed following the VFSS, which helped diagnose the mass as an extensive retropharyngeal abscess with mediastinitis. Following this diagnosis, emergent surgical incision and drainage was performed on the patient. Although the VFSS is primarily designed to evaluate swallowing function rather than to diagnose a disease, it can be used to reveal the primary medical cause of dysphagia while it studies the mechanical and structural abnormalities in the oropharyngeal and esophageal regions. This study also proposes that retropharyngeal abscess should be considered in the differential diagnosis of cases showing progressive dysphagia with fever. As confirmed through this work, the VFSS can function as a useful tool for detecting crucial diseases accompanying deglutition disorder. PMID:22977785

  8. [Lung abscess and necrotizing pneumonia: chest tube insertion or surgery?].

    PubMed

    Pagès, P-B; Bernard, A

    2012-04-01

    Lung abscesses and necrotizing pneumonia are rare complications of community-acquired pneumonia since the advent of antibiotics. Their management leans first of all on the antibiotic treatment adapted on the informed germs. However, in 11 to 20% of the cases of lung abscesses, this treatment is insufficient, and drainage, either endoscopic or percutaneous, must be envisaged. In first intention, we shall go to less invasive techniques: endoscopic or percutaneous radio-controlled. In case of failure of these techniques, a percutaneous surgical drainage by minithoracotomy will be performed. In the necrotizing pneumonia, because of the joint obstruction of the bronchus and blood vessels corresponding to a lung segment, the systemic antibiotic treatment will be poor effective. In case of failure of this one we shall propose, a percutaneous surgical drainage, especially if the necrosis limits itself to a single lobe. The surgical treatment will be reserved: in the failures of the strategy of surgical drainage, in the necroses extending in several lobes. PMID:22361063

  9. [Huge dorsolumbar cold abscess associated with Pott's disease].

    PubMed

    Rakotoson, J L; Rakotomizao, J R; Andrianarisoa, A C F

    2010-12-01

    Pott's disease, or tuberculosis of the spine, is the most common osteoarticular tuberculosis. Among them, dorsolumbar impairment is predominant. The authors report the case of a patient with a huge cold lumbar abscess associated with Pott's disease. The patient is a 32-year-old man presenting dorsolumbar tumefaction associated with an alteration in his general condition and fever for three months. Treatment by "traditional healers" did not provide any improvement. He consulted for mild lumbar pain triggered by fatigue appearing one week before and after the failure of the traditional practitioner. The clinical examination found a temperature of 38.5°C, cachexia, mild lumber kyphosis and impressive, soft, painless and non inflammatory dorsolumbar bruised tumefaction, 40 cm high, 15 cm wide and 7 cm deep. He did not present any neurological signs. The dorsolumbar X-ray of the spine revealed a lesion associated with Pott's disease in the first and second lumbar vertebrae with pinching of the disc, punched-out lesions and osteocondensation. The ultrasound examination of the soft tissue revealed the presence of a laterovertebral collection of fluid diffusing in the subcutaneous region. The psoas major and the paravertebral muscles were not affected. A scan or MRI of the spine was not carried out. Examination of the tissue sample and drainage of the abscess confirmed the tubercular origin. Treatment with tuberculostatic drugs for 12 months associated with immobilisation resulted in a cure with sequelae of mild kyphoscoliosis vertebral statics. PMID:21167445

  10. Amoebic liver abscess: a report from central India.

    PubMed

    Chaudhary, Satyarth; Noor, Mohd Talha; Jain, Sunil; Kumar, Ravindra; Thakur, Bhagwan Singh

    2016-01-01

    Amoebic liver abscess is a serious but curable hepatic illness predominantly seen in tropical countries. We describe our experience of clinical presentation, laboratory parameters, radiological findings and treatment strategies. This is a retrospective analysis of 114 patients who were admitted from January 2012 to September 2014 at our centre. The mean age of presentation was 41.7 ± 13.9 years, the majority of patients were male (86.8%) with chronic alcoholism (63.2%). Most of the patients had a solitary right lobe liver abscess. Abdominal pain, fever, tachycardia and hepatomegaly were the most common clinical findings while hypoalbuminaemia, anaemia, leucocytosis and electrolyte imbalance were the most common laboratory abnormalities. A significant number of patients could be managed with antibiotics only (45.6%), percutaneous radiological drainage techniques being an important adjunct in selected cases (percutaneous needle aspiration, 20.2%; percutaneous pigtail catheter drainage, 30.7%). Surgical intervention was required in only a few cases (3.5%). Mortality was 3.5%. PMID:26156972

  11. Aural abscesses in wild-caught box turtles (Terapene carolina): possible role of organochlorine-induced hypovitaminosis A.

    PubMed

    Holladay, S D; Wolf, J C; Smith, S A; Jones, D E; Robertson, J L

    2001-01-01

    Wild-caught box turtles (Terapene carolina carolina) with aural abscesses were observed over a period of several years. Histopathologic evaluation of epithelial tissues (conjunctiva, pharynx, trachea, auditory tube) revealed mucosal hyperplasia and squamous metaplasia, and accumulated keratin-like material in the middle ear cavity. These manifestations suggested the possibility of vitamin A deficiency. A nonsignificant trend toward reduced serum and hepatic vitamin A levels was observed in turtles with abscesses (mean serum and hepatic vitamin A levels 71 and 49% of respective levels in turtles without abscesses). Three organochlorine (OC) compounds (alpha-benzene hexachloride, heptachlor epoxide, and oxychlordane) and total (microg/g) OC compounds were significantly higher in turtles with abscesses compared with turtles without abscesses. No OC compounds were higher in turtles without abscesses compared with turtles with abscesses. These data suggest a possible effect of environmental chemicals on metabolism or utilization of vitamin A in wild box turtles, resulting in hypovitaminosis A. PMID:11161683

  12. Drainage of pediatric lung abscess by cough, catheter, or complete resection.

    PubMed

    Kosloske, A M; Ball, W S; Butler, C; Musemeche, C A

    1986-07-01

    We treated eight children, aged 7 weeks to 17 years, for lung abscess. Each abscess followed an episode of aspiration or a bacterial pneumonia. Associated conditions were leukemia, congenital immune deficiency, endocarditis, cerebral palsy, and prematurity. Seven of the 8 children had polymicrobial infections, usually containing both aerobic and anaerobic bacteria. The success of medical treatment by antibiotics and chest physiotherapy was age related; 3 of the 8 children, aged 10 to 17 years, recovered on this regimen, whereas five children, aged 7 weeks to 7 years, required catheter drainage or resection for cure. Drainage by catheter pneumonostomy was performed for solitary peripheral bacterial abscesses. A large intercostal catheter was inserted into the cavity, either operatively or percutaneously. Wedge resection was performed for multiple, central, or fungal abscesses. Pneumonostomy was curative in 3 of 4 children. One chronic abscess recurred after pneumonostomy and required resection. Wedge resection was curative in the two children who came to thoracotomy; lobectomy was not necessary. Although all eight children recovered from their lung abscesses, three of them died within a year of sepsis. Lung abscess today occurs in immunocompromised children who are vulnerable to fatal infections. Chest physiotherapy is unlikely to achieve good drainage in children under 7 years of age. Medical failures can be identified within the first week of treatment. Early and aggressive surgical treatment is indicated in such children, and may be lifesaving. PMID:3735040

  13. Potentially Life-Threatening Neck Abscesses: Therapeutic Management Under CT-Guided Drainage

    SciTech Connect

    Thanos, L. Mylona, S.; Kalioras, V.; Pomoni, M.; Batakis, Nikolaos

    2005-04-15

    Purpose. To evaluate the effectiveness of CT-guided drainage of potentially life-threatening neck abscesses. Methods. Between September 2001 and December 2003, 15 patients presented to the emergency room with potentially life-threatening neck abscesses. Their clinical condition was critical due to the abscess size (larger than 3 cm in diameter; mean diameter 5.2 cm, SD 0.91 cm) and/or abscess location. A CT scan was carried out immediately to assess the lesion. At the same time, under CT guidance, an 8 Fr trocar-type pigtail catheter was inserted, in order to drain the abscess. The decision to drain percutaneously was based on a consensus between the surgical, infectious disease and radiology teams. The catheter was kept in place until drainage stopped, and a follow-up scan was performed. Results. In 14 (93%) patients, the abscess was completely drained, and in 1 (7%) case the collection was still present because of multiple internal septation. That patient was treated by surgical management. The catheter was in place for a mean of 3 days (SD 0.96 day). Conclusion. Despite the fact that the number of our patients is small, CT-guided percutaneous drainage seems to be a fast, safe and highly effective low-cost method for the treatment of potentially life-threatening neck abscesses.

  14. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male

    PubMed Central

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-01-01

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere’s disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere’s, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses’ have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy. PMID:25834342

  15. Delayed administration of tissue plasminogen activator reduces intra-abdominal abscess formation.

    PubMed

    McRitchie, D I; Cummings, D; Rotstein, O D

    1989-12-01

    Previous studies demonstrated that intraperitoneal fibrinolysis using tissue plasminogen activator (t-PA) prevented intraabdominal abscess formation in a rat fibrin clot infection model when administered simultaneously with the infecting inoculum. To more closely mimic the clinical setting, the efficacy of delayed administration of t-PA on intra-abdominal abscess formation was examined. A delay of 2, 6, and 18 hours had no effect on the rate of abscess formation but did reduce abscess size, indicating partial fibrinolysis. Since fibrin clots dehydrate in vivo, we hypothesized that a higher concentration of t-PA might be necessary to effect complete abscess resolution. High-dose t-PA (0.1 mg/mL) prevented abscess formation following a 6-hour delay and reduced mean weight following an 18-hour delay. Since heparin sodium may prevent new fibrin deposition and enhance t-PA activity, it was combined with t-PA to investigate potential synergistic effects. Despite adequate anticoagulation with heparin, no synergy with t-PA could be documented. In addition, the combination of antibiotics with t-PA did not affect its efficacy in vivo. We demonstrate that delayed administration of t-PA is effective in preventing abscess formation and may have implications for the clinical setting where initial surgical intervention is usually delayed. PMID:2511820

  16. An intra-cerebral abscess in a patient with Eisenmenger syndrome: An unusual case

    PubMed Central

    Hall, Allan; White, Mark A.J.; Gallo, Pasquale

    2016-01-01

    Introduction We present an unusual case where a large intra-cerebral abscess with severe complications was treated successfully with medical management alone in a patient with Eisenmenger syndrome. Presentation of case A 40 year old patient with Eisenmenger syndrome presented with a seven day history of headache, neck pain and intermittent vomiting and fever. The only neurological examination finding was blurred vision. MRI revealed a large left occipital lobe abscess, which subsequently ruptured into the lateral ventricle with associated ventriculitis and hydrocephalus. This complicated abscess was successfully treated with intravenous antibiotics alone, with complete resolution of the abscess and hydrocephalus on MRI at 13 months post-diagnosis. Discussion Patients with congenital cyanotic heart conditions, like Eisenmenger syndrome, are at increased risk of developing intra-cerebral abscesses. Effectively managing large abscesses with associated intra-ventricular rupture and hydrocephalus in these patients without any form of surgical intervention, including aspiration, is extremely rare. Conclusion Patients with congenital cyanotic heart disease who develop large intra-cerebral abscesses with severe complications, which would normally warrant surgical intervention, have the potential to be successfully treated with antibiotics alone with excellent outcome. PMID:26859871

  17. [A CASE OF MILIARY TUBERCULOSIS ASSOCIATED WITH HEPATOSPLENIC ABSCESSES APPEARING DURING ANTI-TUBERCULOUS TREATMENT].

    PubMed

    Okabayashi, Ken; Nishio, Kazumi; Aida, Shinji; Nakano, Yasushi

    2015-10-01

    A 27-year-old man with a 4-month history of treatment for miliary tuberculosis at another hospital was admitted to our hospital for continued treatment. Computed tomography showed new lesions in the S8 area of the liver and spleen, despite resolution of chest radiographic findings. Because these new lesions were still present after 8 months of treatment, we performed laparoscopic drainage of the liver abscess. Purulent material drained from the lesion revealed positive polymerase chain reaction results for Mycobacterium tuberculosis, and identification of granuloma with infiltrating lymphocytes and plasma cells confirmed the diagnosis of tubercular liver abscess. Pathological changes in the spleen over the clinical course were also regarded as representing tubercular abscess. Postoperative course was good, and tuberculosis treatment ended after 12 months. Tubercular liver abscess subsequently showed prominent reduction, and the tubercular splenic abscess disappeared on abdominal ultrasonography. Tubercular hepatosplenic abscesses appearing during tubercular treatment are rare. We report this valuable case in which laparoscopic drainage of a liver abscess proved useful for diagnosis and treatment. PMID:26821396

  18. Effective photodynamic therapy against microbial populations in human deep tissue abscess aspirates

    PubMed Central

    Haidaris, Constantine G.; Foster, Thomas H.; Waldman, David L.; Mathes, Edward J.; McNamara, JoAnne; Curran, Timothy

    2014-01-01

    Background and Objective The primary therapy for deep tissue abscesses is drainage accompanied by systemic antimicrobial treatment. However, the long antibiotic course required increases the probability of acquired resistance, and the high incidence of polymicrobial infections in abscesses complicates treatment choices. Photodynamic therapy (PDT) is effective against multiple classes of organisms, including those displaying drug resistance, and may serve as a useful adjunct to the standard of care by reduction of abscess microbial burden following drainage. Study Design/Materials and Methods Aspirates were obtained from 32 patients who underwent image-guided percutaneous drainage of the abscess cavity. The majority of the specimens (24/32) were abdominal, with the remainder from liver and lung. Conventional microbiological techniques and nucleotide sequence analysis of rRNA gene fragments were used to characterize microbial populations from abscess aspirates. We evaluated the sensitivity of microorganisms to methylene blue-sensitized PDT in vitro both within the context of an abscess aspirate and as individual isolates. Results Most isolates were bacterial, with the fungus Candida tropicalis also isolated from two specimens. We examined the sensitivity of these microorganisms to methylene blue-PDT. Complete elimination of culturable microorganisms was achieved in three different aspirates, and significant killing (p < 0.0001) was observed in all individual microbial isolates tested compared to controls. Conclusions These results and the technical feasibility of advancing optical fibers through catheters at the time of drainage motivate further work on including PDT as a therapeutic option during abscess treatment. PMID:23996629

  19. Limitations of using imaging diagnosis for psoas abscess in its early stage.

    PubMed

    Takada, Toshihiko; Terada, Kazuhiko; Kajiwara, Hideki; Ohira, Yoshiyuki

    2015-01-01

    Objective Patients diagnosed with psoas abscess have a high mortality rate. The major cause of its poor prognosis is delayed treatment. Therefore, making a correct diagnosis rapidly is important. Both computed tomography (CT) and magnetic resonance imaging (MRI) are considered to be the gold standards as imaging modalities that have a high sensitivity for detecting psoas abscess. There have been few reports regarding the limitations of these methods, but psoas abscess in its early stage may go undetected by CT and MRI. Methods Detection of psoas abscess by CT and MRI was investigated in the present study through a retrospective review of 15 patients in whom psoas abscess was diagnosed during a course of ten years at our hospital. Results In all patients, psoas abscess was diagnosed by at least a plain CT, enhanced CT, and/or plain MRI. The interval between the onset of symptoms and diagnosis was 20.9±17.9 days (mean ± standard deviation). In three patients, repeat imaging identified a psoas abscess, whereas initial imaging failed to detect it. The overall sensitivity of plain CT, enhanced CT, and plain MRI for psoas abscess was 78%, 86%, and 88%, respectively. From six days after the onset of symptoms, the sensitivity of each modality was 100%, while the sensitivity from day one to five days was only 33%, 50%, and 50%, respectively. Conclusion Although CT and MRI are considered to be gold standard modalities for diagnosing psoas abscess, both methods can fail to notice this condition in its early stage. PMID:26466693

  20. High prevalence of abscesses and self-treatment among injection drug users in Tijuana, Mexico

    PubMed Central

    Pollini, Robin A.; Gallardo, Manuel; Hasan, Samreen; Minuto, Joshua; Lozada, Remedios; Vera, Alicia; Ziga, Mara Luisa; Strathdee, Steffanie A.

    2010-01-01

    Summary Background Soft tissue infections are common among injection drug users (IDUs), but information on correlates and treatment in this highly marginalized population is lacking. Methods Six hundred twenty-three community-recruited IDUs in Tijuana, Mexico, completed a detailed interview on abscess history and treatment. Univariate and multiple logistic regressions were used to identify factors independently associated with having an abscess in the prior 6 months. Results Overall, 46% had ever had an abscess and 20% had had an abscess in the past 6 months. Only 12% had sought medical care for their most recent abscess; 60% treated the abscess themselves. The most common self-treatment method was to apply heated (24%) or unheated (23%) Aloe vera leaf. Other methods included draining the wound with a syringe (19%) or knife (11%). Factors independently associated with recent abscess were having income from sex work (adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI) 2.0810.00), smoking methamphetamine (aOR 1.65, 95% CI 1.052.62), seeking someone to help with injection (aOR 2.06, 95% CI 1.183.61), and reporting that police affected where they used drugs (aOR 2.14, 95% CI 1.153.96). Conclusions Abscesses are common among IDUs in this setting, but appropriate treatment is rare. Interventions to reduce barriers to medical care in this population are needed. Research on the effectiveness of Aloe vera application in this setting is also needed, as are interventions to provide IDU sex workers, methamphetamine smokers, and those who assist with injection with the information and equipment necessary to reduce abscess risk. PMID:20381396

  1. EPIZOOTIOLOGY OF CRANIAL ABSCESS DISEASE IN WHITE-TAILED DEER (ODOCOILEUS VIRGINIANUS) OF GEORGIA, USA.

    PubMed

    Cohen, Bradley S; Belser, Emily H; Killmaster, Charlie H; Bowers, John W; Irwin, Brian J; Yabsley, Michael J; Miller, Karl V

    2015-07-01

    Intracranial abscess disease is a cause of natural mortality for mature male white-tailed deer (Odocoileus virginianus). Most cases of abscesses are associated with bacterial infection by Trueperella (Arcanobacterium) pyogenes, but a complete understanding of the epidemiology of this disease is lacking. We quantified the effects of individual characteristics, site-specific herd demographics, land cover, and soil variables in estimating the probability of this disease. We examined 7,545 white-tailed deer from 60 sites throughout Georgia US for signs of cranial abscesses, the predecessor of intracranial abscesses, and recorded the presence or absence of cranial abscesses for each individual examined. We detected no cranial abscesses in 2,562 female deer but 91 abscesses in 4,983 male deer examined (1.8%). A generalized linear mixed model, treating site as a random effect, was used to examine several potential explanatory risk factors including site-level landscape and soil characteristics (soil and forest type), demographic factors (deer density and male to female ratio), and individual host factors (deer sex and age). Model results indicated that the probability of a male having a cranial abscess increased with age and that adult sex ratio (male:female) was positively associated with this disease. Site-specific variables for land cover and soil types were not strongly associated with observations of the disease at the scale measured and a large amount of among-site variability remained. Given the demonstrated effect of age, gender, and local sex ratios but the remaining unexplained spatial variability, additional investigation into spatiotemporal variation of the presumed bacterial causative agent of cranial abscesses appears warranted. PMID:25984774

  2. Bursae and abscess cavities communicating with the hip: diagnosis using arthrography and CT

    SciTech Connect

    Steinbach, L.S.; Schneider, R.; Goldman, A.B.; Kazam, E.; Ranawat, C.S.; Ghelman, B.

    1985-08-01

    Bursae or abscess cavities communicating with the hip joint were demonstrated by hip arthrography or by computed tomography (CT) in 40 cases. The bursae or abscess cavities were associated with underlying abnormalities in the hip, including painful hip prostheses, infection, and inflammatory or degenerative arthritis. Symptoms may be produced directly as a result of infection or indirectly as a result of inflammation or pressure on adjacent structures. Hip arthrography can confirm a diagnosis of bursae and abscess cavities communicating with the hip joint in patients with hip pain or soft-tissue masses around the groin. Differentiation of enlarged bursae from other abnormalities is important to avoid unnecessary or incorrect surgery.

  3. [Treatment of patients with lung abscess by local administration of papain].

    PubMed

    Udod, V M; Kolos, A I; Gritsuliak, Z N

    1989-03-01

    Under study were results of treatment of 109 patients with lung abscess aged from 17 to 76 years. All the patients were treated by active antiinflammatory therapy, bronchosanitation measures. In addition, local treatment by transthoracal punctures and drainage of the abscess cavity was used. Patients of the main group (52 patients) were given transthoracal injections of 0.5% solution of papain. The inclusion of papain in the complex therapy of patients with a lung abscess allowed to improve results of the treatment of this severe disease. The method may be recommended for wide use in pulmonology. PMID:2665304

  4. Clinical and echocardiographic findings in an 8 year old Brown Swiss cow with myocardial abscess.

    PubMed

    Gerspach, C; Schwarzwald, C C; Hilbe, M; Buczinski, S

    2016-06-01

    Intramyocardial abscesses are rare in cattle and may lead to unspecific clinical signs. This case report describes the clinical and echocardiographic findings in an 8 year old Brown Swiss cow presented with an intramural myocardial abscess. The main clinical findings were anorexia, drop in milk yield, fever, tachycardia, and hyperfibrinogenemia. Neither heart murmurs nor cardiac arrhythmias were present on auscultation. Transthoracic echocardiographic examination revealed a prominent intramural mass embedded in the left ventricular free wall and bulging into the lumen of the left ventricle. Diagnosis was confirmed at necropsy. A culture of the abscess grew Trueperella pyogenes. PMID:26900053

  5. Emergent Airway Management of an Uncooperative Child with a Large Retropharyngeal and Posterior Mediastinal Abscess.

    PubMed

    Diep, Jack; Kam, David; Kuenzler, Keith A; Arthur, Jill F

    2016-02-01

    Retropharyngeal abscesses are deep neck space infections that can lead to life-threatening airway emergencies and other catastrophic complications. Retropharyngeal abscesses demand prompt diagnosis and early establishment of a definitive airway when there is airway compromise. This can be difficult in an uncooperative patient. We present the case of a 12-year-old girl with mediastinitis and tracheal compression and anterior displacement from a large retropharyngeal and posterior mediastinal abscess secondary to traumatic esophageal perforation, who received successful awake nasal fiberoptic intubation. Anesthesiologists must be prepared for airway emergencies in uncooperative patients, especially children, but there is controversy concerning the use of sedation. PMID:26599735

  6. Subcutaneous abscess caused by Clostridium perfringens and osteomyelitis in a dog.

    PubMed

    Cattin, I; Liehmann, L; Ammon, P; Dupre, G

    2008-04-01

    A case of a subcutaneous abscess caused by Clostridium perfringens infection in a five-month-old dog is reported in this study. Clinical examination, radiological findings and cytological analysis of abscess fluid were consistent with Clostridium induced disease. Treatment including drainage of the abscess and antibiotic therapy led to rapid clinical improvement. However, despite aggressive medical therapy and proper wound care, the deep soft tissue infection led to osteomyelitis with premature closure of the growth plates of the tibia and secondary bone shortening. Prolonged treatment with metronidazole and amoxicillin-clavulanic acid resulted in an excellent outcome with normal weight bearing. PMID:18086156

  7. Gallium-SPECT in the detection of prosthetic valve endocarditis and aortic ring abscess

    SciTech Connect

    O'Brien, K.; Barnes, D.; Martin, R.H.; Rae, J.R. )

    1991-09-01

    A 52-yr-old man who had a bioprosthetic aortic valve developed Staphylococcus aureus bacteremia. Despite antibiotic therapy he had persistent pyrexia and developed new conduction system disturbances. Echocardiography did not demonstrate vegetations on the valve or an abscess, but gallium scintigraphy using SPECT clearly identified a focus of intense activity in the region of the aortic valve. The presence of valvular vegetations and a septal abscess was confirmed at autopsy. Gallium scintigraphy, using SPECT, provided a useful noninvasive method for the demonstration of endocarditis and the associated valve ring abscess.

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

    PubMed

    Sassa, Tatsuro; Kobayashi, Ken-Ichiro; Ota, Masayuki; Washino, Takuya; Hikone, Mayu; Sakamoto, Naoya; Iwabuchi, Sentaro; Otsuji, Mizuto; Ohnishi, Kenji

    2015-12-01

    Most mediastinal abscesses result from infections after thoracotomy, esophageal perforation or pene- trating chest trauma. This disease is rarely caused by closed blunt chest trauma. All previously reported such cases after closed blunt chest trauma presented with hematoma and sternal osteomyelitis resulting from sternal fracture. Here we report a 15-year-old sumo wrestler who presented with an anterior mediastinal abscess without any mediastinal fracture. The mediastinal abscess resulted from the hematogenous spread of Staphylococcus aureus to a hematoma that might have been caused by a closed blunt chest trauma incurred during sumo wrestling exercises. PMID:26917029

  9. First report of a thyroid abscess in the pediatric age group caused by Arcanobacterium haemolyticum.

    PubMed

    Sayyahfar, Shirin; Nasiri, Seyed Javad

    2012-08-01

    Thyroid abscess is a rare event especially in the pediatric age group. We report a 2-year-old girl with thyroid abscess who presented with fever and an anterior painful neck mass. Culture of the aspirated fluid yielded Arcanobacterium haemolyticum, which is one of the etiologies of pharyngitis and rash in children and, especially, young adults. As far as we are aware this is the first report of thyroid abscess in the pediatric or adult age group caused by Arcanobacterium haemolyticum. PMID:22286406

  10. Percutaneous Management of Abscess and Fistula Following Pancreaticoduodenectomy

    SciTech Connect

    AAssar, O. Sami; LaBerge, Jeanne M.; Gordon, Roy L.; Wilson, Mark W.; Mulvihill, Sean J.; Way, Lawrence W.; Kerlan, Robert K.

    1999-01-15

    Purpose: To evaluate the efficacy of percutaneous drainage of fluid collections following pancreaticoduodenectomy (Whipple's procedure). Methods: We performed a retrospective review of 19 patients referred to our service with fluid collections following pancreaticoduodenectomy. The presence of associated enteric or biliary fistulas, the route(s) of access for image-guided drainage, the incidence of positive bacterial cultures, and the duration and success of percutaneous management were recorded. Results: Fistulous communication to the jejunum in the region of the pancreatico-jejunal anastomosis was demonstrable in all 19 patients by gentle contrast injection into drainage tubes. Three patients had concurrent biliary fistulas. In 18 of 19 patients, fluid samples yielded positive bacterial cultures. Successful percutaneous evacuation of fluid was achieved in 17 of 19 patients (89%). The mean duration of drainage was 31 days. Conclusion: Percutaneous drainage of abscess following pancreaticoduodenectomy is effective in virtually all patients despite the coexistence of enteric and biliary fistulas.

  11. Tuberculous paraspinal abscess: a case of mistaken identity.

    PubMed

    Crooks, Michael G; Hill, Adam T

    2011-02-01

    We present the case of a 35-year-old man of Pakistani origin presenting with a history suggestive of tuberculosis. Chest x-ray revealed left upper zone consolidation and mediastinal widening felt to be consistent with mediastinal lymphadenopathy. Bronchoalveolar lavage failed to yield acid-fast bacilli (AFB) and therefore CT thorax was requested with a view to surgical referral for mediastinal node biopsy. CT thorax revealed a large paravertebral abscess to be the cause of apparent mediastinal widening. CT guided biopsy confirmed Mycobacterium tuberculosis on culture. On reflection, there was preservation of the right paratracheal stripe on chest x-ray indicating that this was not mediastinal lymphadenopathy but a paravertebral mass as illustrated on CT. PMID:21515538

  12. Recurrent Soft Tissue Abscesses Caused by Legionella cincinnatiensis

    PubMed Central

    Gubler, Jacques G. H.; Schorr, Mirjam; Gaia, V.; Zbinden, R.; Altwegg, M.

    2001-01-01

    Recurrent soft tissue abscesses of the jaw, wrist, and arm developed in a 73-year-old housewife with nephrotic syndrome and immunoglobulin A(κ) gammopathy of unknown etiology. Conventional cultures remained negative, despite visible gram-negative rods on microscopy. Broad-spectrum PCR revealed Legionella cincinnatiensis, which was confirmed by isolation of the organism on special Legionella medium. Infections due to Legionella species outside the lungs are rare. L. cincinnatiensis has been implicated in only four cases of clinical infection; these involved the lungs in three patients and the central nervous system in one patient. We conclude that broad-spectrum PCR can be a valuable tool for the evaluation of culture-negative infections with a high probability of bacterial origin and that Legionella might be an underdiagnosed cause of pyogenic soft tissue infection. PMID:11724886

  13. Spinal subdural abscess: a rare complication of decubitus ulcer.

    PubMed

    Usoltseva, Natalia; Medina-Flores, Rafael; Rehman, Ateeq; Samji, Swetha; D'Costa, Matthew

    2014-09-01

    Spinal subdural abscess (SSA) is an uncommon entity. The exact incidence is unknown, with very few cases reported in the literature. This condition may result in spinal cord compression, thus constituting a medical and neurosurgical emergency. The pathogenesis of SSA is not well-described, and the available knowledge is based on case observations only. There is only one case report that describes direct seeding from decubitus ulcers as a possible mechanism for development of SSA. We report a case of subacute onset of quadriplegia in a male patient, age 55 years, due to spinal cord compression from SSA and superimposed spinal subdural hematoma. The direct seeding from decubitus ulcers is thought to be the cause of infection in our patient. We present this case of SSA to elucidate and review the predisposing factors, pathogenesis, clinical presentation, diagnostic modalities, and treatment regarding management of this rare disorder. PMID:24667217

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

    PubMed

    Bhat, G Subraya; Singh, Vishal; Bhat, K Mahalinga

    2012-01-01

    We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology. PMID:22628975

  15. [Indication for surgical therapy of tubo-ovarian abscess].

    PubMed

    Moldenhauer, M; Link, H

    1978-01-01

    It is reported about the indication to operative therapy, therapy-shape and the going of cure of 30 patients suffering from tuboovarian abscesses. At the beginning there is the conservative therapy with general measures immediately dose of antibiotica without waiting for the germ and resistence determinations. However the well timed operative therapy under conditions as well as possible is deciding. As a rule the abdominal exstirpation of the uterus with both adnexe is practiced in order to come to a complete removal of the infection hearth. --The postoperative cours war only febril in one third of the treated women. In 86,7% the laparotomy scare healed per primam intentionem. We didn't observe an extension of the infection post operationem and there were not any complications with letal exit. PMID:654673

  16. Unusual presentation of filariasis as an abscess: A case report

    PubMed Central

    Ahuja, Mukta; Pruthi, Sonam Kumar; Gupta, Renu; Khare, Pratima

    2016-01-01

    Bancroftian filariasis, a tropical and subtropical disease caused by Wuchereria bancrofti, is transmitted by the culex mosquito. The disease is conventionally diagnosed by the demonstration of microfilaria in peripheral blood smear. Microfilaria and adult filarial worms have been incidentally detected in fine needle aspiration cytology (FNAC) in various locations. The disease may be missed if one is not aware of the possibility, particularly in cases where eosinophilia is absent. Therefore, clinicians and pathologists need to be more vigilant in the endemic zones for early diagnosis and the treatment of filariasis. We report here an unusual case of filariasis in a 17-year-old female with a swelling in the lower part of the left arm on the flexor surface. This highlights the chances of finding microfilaria in cytology of an unsuspected case at an unusual site. This case, in addition, stresses the fact that microfilaria may be associated with an abscess even in the absence of eosinophilia. PMID:27011444

  17. Primary Aspergillus sellar abscess simulating pituitary tumor in immunocompetent patient.

    PubMed

    Ouyang, Taohui; Zhang, Na; Wang, Long; Jiao, Jiantong; Zhao, Yiqing; Li, Zheng; Chen, Jian

    2015-03-01

    A 55-year-old woman presented with headache, dizziness, and decreased visual acuity. Magnetic resonance imaging revealed a sellar mass with sphenoid sinus extension. The result of hormone showed an obviously high prolactin (815 ng/mL). The mass was resected and diagnosed with aspergillosis pathologically. Postoperatively, the level of prolactin dramatically decreased, and the patient received medical treatment with voriconazole and caspofungin. During a 6-month follow-up, the patient's headache and dizziness disappeared, and visual acuity improved. Therefore, aspergillus sellar abscess could result in hyperprolactinemia and should be considered in the differential diagnosis of a sellar mass, even in immunocompetent patients. A combination of surgery and antifungal therapy could reduce the hyperprolactinemia and improve symptoms. PMID:25675014

  18. Transorbital Craniocerebral Occult Penetrating Injury with Cerebral Abscess Complication

    PubMed Central

    Abdulbaki, Arif; Al-Otaibi, Faisal; Almalki, Amal; Alohaly, Nasser; Baeesa, Saleh

    2012-01-01

    Transorbital intracranial penetrating injury is an uncommon mechanism of head injury. These injuries can be occult during the initial clinical presentation. Certain patients develop an intracranial cerebral infection. Herein, we report a 5-year-old child with an occult transorbital intracranial penetrating injury caused by a pen. A retained pen tip was found at the superior orbital roof and was not noticed at initial presentation. This was complicated by a right frontal lobe cerebral abscess. This paper emphasizes the importance of orbitocranial imaging in any penetrating orbital injury. A review of the literature on intracranial infection locations in relation to the route and mechanism of injury is included to complement this report. PMID:23097729

  19. [Clinical Analyses of 115 Patients with Peritonsillar Abscess].

    PubMed

    Umibe, Akiko; Anazawa, Utaro; Kessoku, Hisashi; Takaishi, Shinya; Hachisu, Takuya; Masuda, Ayako; Yoshimura, Tsuyoshi; Iino, Takashi; Tanaka, Yasuhiro

    2015-10-01

    The clinical data of 115 patients with peritonsillar abscess (98 men and 17 women) treated between May 2011 and March 2014 were analyzed. We examined 9 items; the age, sex, affected side, duration of hospitalization, method of drainage, smoking history, history of diabetes, antibacterial drugs used, and the isolated bacteria. The disease predominantly affected males in their 30s (27.8% of all the patients). The median duration of hospitalization was 7 days. In regard to the affected side, the right side was affected in 52%, the left side in 44%, and both sides in 4%. The method of drainage used was incision in 63%, and puncture in 37%. In regard to the personal and past medical history, 51% of patients had a history of smoking and 3.5% had a history of diabetes. ABPC/SBT was used as the single-agent antibacterial drug in 75% of cases. The most commonly isolated aerobic bacteria were α-hemolytic streptococci, and the most commonly isolated anaerobic bacteria were Prevotella. The duration of hospitalization showed no significant correlation with the smoking history, drainage method or the antibiotic treatment used (ABPC/SBT single-agent or multiple drug use). On the other hand, the duration of hospitalization was significantly longer in the more than ≥65 years' age group than in the <65 years' age group. Therefore, especially careful interventions for prevention and treatment of peritonsillar abscess are required in the elderly. In relation to antibiotic selection, it may be reasonable to expect sufficient effect with the use of ABPC/SBT as a single agent, as this antibiotic has a broad antibacterial spectrum covering aerobic, anaerobic and drug-resistant bacteria. PMID:26727821

  20. Surgery for Aortic Root Abscess: A 15-Year Experience

    PubMed Central

    Sarikaya, Sabit; Ozen, Yucel; Sacli, Hakan; Basaran, Eylul; Yerlikhan, Ozge Altas; Aydin, Ebuzer; Rabus, Murat Bulent

    2016-01-01

    Aortic root abscess is the most severe sequela of infective endocarditis, and its surgical management is a complicated procedure because of the high risk of morbidity and death. Twenty-seven patients were included in this 15-year retrospective study: 21 (77.8%) with native- and 6 (22.2%) with prosthetic-valve endocarditis. The surgical reconstruction of the aortic root consisted of aortic valve replacement in 19 patients (70.4%) with (11) or without (8) a pericardial patch, or total aortic root replacement in 7 patients (25.9%); 5 of the 27 (18.5%) underwent the modified Bentall procedure with the flanged conduit. Only one patient (3.7%) underwent subaortic pericardial patch reconstruction without valve replacement. A total of 7 patients (25.9%) underwent reoperation: 6 with prior valve surgery, and 1 with prior isolated sinus of Valsalva repair. The mean follow-up period was 6.8 ± 3.7 years. There were 6 (22.2%) in-hospital deaths, 3 (11.1%) of which were perioperative, among patients who underwent emergent surgery. Five patients (23.8%) died during follow-up, and the overall survival rates at 1, 5, and 10 years were 70.3% ± 5.8%, 62.9% ± 6.4%, and 59.2% ± 7.2%, respectively. Two of 21 patients (9.5%) underwent reoperation because of paravalvular leakage and early recurrence of infection during follow-up. After complete resection of the perianular abscess, replacement of the aortic root can be implemented for reconstruction of the aortic root, with or without left ventricular outflow tract injuries. Replacing the aortic root with a flanged composite graft might provide the best anatomic fit. PMID:27047281

  1. Iliopsoas abscess as a complication of tunneled jugular vein catheterization in a hemodialysis patient.

    PubMed

    Hsiao, Po-Jen; Tsai, Ming-Hsien; Leu, Jyh-Gang; Fang, Yu-Wei

    2015-04-01

    Iliopsoas abscess is a rare complication in hemodialysis patients that is mainly due to adjacent catheterization, local acupuncture, discitis, and bacteremia. Herein, we report a 47-year-old woman undergoing regular hemodialysis via a catheter in the internal jugular vein who presented with low back pain and dyspnea. A heart murmur suggested the presence of catheter-related endocarditis, and this was confirmed by an echocardiogram and a blood culture of methicillin-resistant Staphylococcus aureus. A computed tomography indicated a pulmonary embolism and an incidental finding of iliopsoas abscess. Following surgical intervention and intravenous daptomycin, the patient experienced full recovery and a return to usual activities. This case indicates that an iliopsoas abscess can be related to a jugular vein catheter, which is apparently facilitated by infective endocarditis. The possibility of iliopsoas abscess should be considered when a hemodialysis patient presents with severe low back pain, even when there is no history of adjacent mechanical intervention. PMID:25040197

  2. Abdominal abscess due to retained gallstones 5 years after laparoscopic cholecystectomy.

    PubMed

    Awwad, Amir; Mulholland, Keith; Clements, Barry

    2010-01-01

    A 76-year-old female patient with diabetes presented with pyrexia and a recurrent painful right sided loin swelling. One year previously she had undergone radiological drainage of a large right sided loin abscess. At index presentation she was investigated both radiologically and endoscopically and a source for the abscess was not found. On this presentation, a computed tomography scan confirmed a large retroperitoneal abscess pointing through the lateral abdominal wall musculature. Surgical drainage was undertaken whereby the abscess was drained and several large gallstones extruded through the incision. The patient subsequently recuperated and the wound has healed successfully by second intention. Five years previously the patient had undergone an "uncomplicated" laparoscopic cholecystectomy. This case highlights the catastrophic late effects of dropped gallstones during laparoscopic cholecystectomy. PMID:22242063

  3. Abdominal abscess due to retained gallstones 5 years after laparoscopic cholecystectomy

    PubMed Central

    Awwad, Amir; Mulholland, Keith; Clements, Barry

    2010-01-01

    A 76-year-old female patient with diabetes presented with pyrexia and a recurrent painful right sided loin swelling. One year previously she had undergone radiological drainage of a large right sided loin abscess. At index presentation she was investigated both radiologically and endoscopically and a source for the abscess was not found. On this presentation, a computed tomography scan confirmed a large retroperitoneal abscess pointing through the lateral abdominal wall musculature. Surgical drainage was undertaken whereby the abscess was drained and several large gallstones extruded through the incision. The patient subsequently recuperated and the wound has healed successfully by second intention. Five years previously the patient had undergone an “uncomplicated” laparoscopic cholecystectomy. This case highlights the catastrophic late effects of dropped gallstones during laparoscopic cholecystectomy. PMID:22242063

  4. Specific but limited role of new imaging techniques in decision-making about intraabdominal abscesses

    SciTech Connect

    Wright, H.K.; Dunn, E.; MacArthur, J.D.; Pelliccia, O.

    1982-04-01

    Despite the very high accuracy rate of imaging studies (ultrasound, computed tomography, liver-lung-spleen scans and /sup 67/Ga scans) in detecting intraabdominal abscesses, our experience with 80 recent cases indicate that these techniques have not significantly altered traditional methods of decision-making about when and where to drain such abscesses. In only 12.5 percent of cases were such decisions based on special imaging techniques alone, and most of these cases subphrenic abscesses were diagnosed late after surgery. In the remainder, physical examination and routine radiologic studies sufficed, with special imaging techniques primarily corroborating clinical evidence based on these methods. We conclude that the use of special imaging techniques alone in a search for the cause of fever early after abdominal surgery does not provide evidence upon which clinical decisions can be based unless there are already physical signs of an abscess.

  5. Isolated Bilateral Renal Mucormycosis Masquerading as Renal Abscess in an Immunocompetent Individual: A Lesson Learnt

    PubMed Central

    Paonam, Somorendro; Bag, Sananda; Mavuduru, Ravimohan S.; Agarwal, Mayank Mohan; Mandal, Arup Kumar

    2014-01-01

    Isolated renal mucormycosis is a rare entity in immunocompetent subjects. It is usually a rapidly progressive disease with poor prognosis but it can mimic renal abscess with a protracted course. PMID:25587482

  6. Paraspinal and Extensive Epidural Abscess: The Great Masqueraders of Abdominal Pain

    PubMed Central

    Chu, Andrew; Aung, Thu Thu; Shankar, Uday

    2015-01-01

    Paraspinal and epidural abscesses are rare conditions often diagnosed later in the disease process that can have significant morbidity and mortality. Predisposing risk factors include diabetes, human immunodeficiency virus, intravenous drug abuse, and previous history of spinal surgery or injection. They can threaten the spinal cord by compressive effect, leading to sensory motor deficits and ultimately paralysis and death. Diagnosis may be a challenge due to the delayed presentation of nonspecific back pain or radicular pain such as chest pain or abdominal pain. We present a rare case on a patient with periumbilical pain, constipation, and urinary retention who was ultimately diagnosed with a paraspinal abscess extending into the epidural space from T1 to S2. He underwent decompressive laminectomy with incision and drainage of the abscesses. The patient made an excellent recovery postoperatively, and repeat magnetic resonance imaging at six weeks showed resolution of the abscess. PMID:26770847

  7. Splenic abscess due to Salmonella schwarzengrund in a previously healthy individual returning from Bali.

    PubMed

    Hoff, Erik; Nayeri, Fariba

    2015-01-01

    After an episode of diarrhoea, a previously healthy young man developed a splenic abscess due to invasive non-typhoidal Salmonella. The patient was presented with >1 month of fever, diffuse abdominal pain, raised C reactive protein and increased white cell count. Ultrasonography revealed a 5 × 5 cm abscess in the spleen. After an unsuccessful treatment attempt with percutaneous drainage and antibiotics, the patient was successfully treated with splenectomy and antibiotics. This case highlights the difficulties inherent in making a correct diagnosis of splenic abscess in patients without risk factors. Splenic abscess is rare in previously healthy individuals. Antibiotics are inadequate as a sole treatment, and percutaneous drainage is usually only a temporary solution. Splenectomy is still the standard treatment in most cases. PMID:26670898

  8. Radiologic diagnosis of an intra-abdominal abscess. Do multiple tests help

    SciTech Connect

    Dobrin, P.B.; Gully, P.H.; Greenlee, H.B.; Freeark, R.J.; Moncada, R.; Churchill, R.; Reynes, C.; Henkin, R.

    1986-01-01

    A review was made of the charts of 94 patients who underwent ultrasonography (US), computed tomography (CT), and gallium citrate Ga 67 (Gall) scan to rule out intra-abdominal abscesses. Of all the clinical and laboratory data, only the presence of pain and tenderness differentiated patients with and without abscesses. A review of radiologic data showed that CT was superior to US, and that US was superior to Gall scan with regard to sensitivity, specificity, accuracy, and positive and negative predictive values. When multiple radiologic tests were performed, results agreed in 72% of cases; therefore, the additional tests were essentially redundant. When radiologic test results disagreed, accuracy rates were CT, 0.86; US, 0.00; and Gall scan, 0.44. These findings suggest that, except to rule out pelvic abscesses in the presence of pelvic inflammatory disease, CT is usually the only special radiologic test that should be performed to localize a suspected intra-abdominal abscess.

  9. Detection of a prosthetic aortic valvular abscess with indium-111-labeled leukocytes

    SciTech Connect

    Oates, E.; Sarno, R.C.

    1988-10-01

    An unsuspected annular abscess at the base of a prosthetic aortic valve in a patient with endocarditis was identified by indium-111-labeled leukocyte scintigraphy alone. This highly sensitive and specific technique expediently demonstrated the surgically proven inflammatory focus.

  10. Isolated extraocular muscle abscess presenting 40 years after squint surgery

    PubMed Central

    Lim, Wei Sing; Aclimandos, Wagih; Pringle, Edward; Shah, Brinda

    2014-01-01

    A 57-year-old man presented with an abscess localised to the lateral rectus region. He was treated as a case of orbital cellulitis because of the presence of soft tissue swelling with a localised abscess discharging through the conjunctiva with associated reduction of visual acuity and restriction of ocular movements laterally. No specific risk factors were identified but an ultrasound scan picked up a hyperechoic signal suggestive of a foreign body within the abscess. Surgical exploration did not identify a foreign body but fibrotic changes between the globe and the lateral rectus muscle were found which was suggestive of previous squint surgery. This was confirmed by the patient later on specific questioning. Periorbital infection is a rare occurrence after squint surgery and reported cases are mainly within a week after surgery. Orbital abscess probably related to an old suture granuloma 40 years after surgery has not been documented before. PMID:24706710

  11. Recurrent abscesses due to Finegoldia magna, Dermabacter hominis and Staphylococcus aureus in an immunocompetent patient.

    PubMed

    Martin, J; Bemer, P; Touchais, S; Asseray, N; Corvec, S

    2009-10-01

    A case of recurrent abscesses in an immunocompetent patient is reported, involving the opportunistic human pathogen Dermabacter hominis, the virulent anaerobic pathogen Finegoldia magna and Staphylococcus aureus. PMID:19332143

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

    PubMed Central

    Pangonis, Scott; Patamasucon, Pisespong; Fitzpatrick, Ellen

    2016-01-01

    Streptococcus pneumoniae is an invasive organism that causes a wide range of common diseases, including sinusitis, acute otitis media, and pneumonia. Splenic abscesses and purpura fulminans (PF) are rare complications of pneumococcal disease. Splenic abscesses caused by S pneumoniae have only been reported in the adult literature. PF has been described in the pediatric population as a rare complication in patients with invasive pneumococcal disease (IPD) with and without underlying immunological disorders such as asplenia. Here, we report a patient with IPD complicated by splenic abscesses and PF. Our patient initially presented with bacteremia, septic shock, and disseminated intravascular coagulation. She subsequently developed PF and splenic abscesses. She survived her illness after receiving a total of 8 weeks of antibiotic therapy. This case highlights 2 rare complications of IPD and demonstrates the need to keep pneumococcal disease in the differential diagnosis even in children whose vaccination status is up to date. PMID:27006958

  13. Clinical Immunology Review Series: An approach to the patient with recurrent superficial abscesses

    PubMed Central

    Johnston, S L

    2008-01-01

    ARTICLES PUBLISHED IN THIS CLINICAL IMMUNOLOGY REVIEW SERIES allergy in childhood, allergy diagnosis by use of the clinical immunology laboratory, anaphylaxis, angioedema, management of pulmonary disease in primary antibody deficiency, recurrent infections in childhood, recurrent infections in adulthood, recurrent oro-genital ulceration, recurrent superficial abscesses, urticaria, vasculitis/CTD Patients may be referred to the immunology clinic for investigation of recurrent superficial abscess formation. In the majority of adult patients this clinical presentation does not equate with an underlying primary immune deficiency. Nevertheless, recurrent mucocutaneous abscesses can be associated with significant morbidity and long-term complications, including scarring and fistula formation, and may be associated with underlying immune-mediated disease. This review sets out an approach to the patient with recurrent superficial abscesses, focusing on the differential diagnoses, investigation and management of both the common causes and those associated with specific immune deficiency. PMID:18422735

  14. Gallstones in a retroperitoneal abscess: a late complication of perforation of the gallbladder.

    PubMed

    Jacob, H; Rubin, K P; Cohen, M C; Kahn, I J; Kan, P

    1979-12-01

    The case of a 72-year-old female with a retroperitoneal abscess which contained cholesterol gallstones is presented. The pathogenesis of this unusual complication of gallbladder disease is discussed. PMID:510099

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

    PubMed Central

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

    2013-01-01

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

  16. A vaginal drain of a pelvic abscess due to colonic diverticulitis

    PubMed Central

    Milone, Marco; Sosa Fernandez, Miguel Emilio; Venetucci, Piero; Maietta, Paola; Sosa Fernandez, Loredana Maria; Taffuri, Caterina; Milone, Francesco

    2013-01-01

    Although well recognized for tubo-ovarian abscesses, we report, in our best knowledge, the first case of a vaginal drain of a pelvic abscess due to colonic diverticulitis. A 78-year-old patient presented with abdominal and pelvic pain, fever (39.3 °C) and an elevated white blood cell count (18500/mL). After abdominopelvic computed tomography the patient was presumed to have a pelvic abscess, which developed as a complication of the sigmoid diverticulitis. Due to the numerous intervening structures that create obstacles to safe percutaneous access, we planned a trans-vaginal drain. A rapid recovery was obtained within 2 d from the procedure and, at present, the follow-up was uneventful after 18 mo. We believe that transvaginal drain of pelvic abscess could be a useful alternative, when percutaneous approach is not feasible. PMID:24303472

  17. Herpes zoster ophthalmicus presenting as orbital abscess along with superior orbital fissure syndrome: A case report

    PubMed Central

    Lavaju, Poonam; Badhu, Badri Prasad; Shah, Sangeeta

    2015-01-01

    Orbital abscess and superior orbital fissure syndrome (SOFS) are rare manifestations of herpes zoster ophthalmicus. Herein, we report a case of orbital abscess along with SOFS in a 2.5-year-old-male child secondary to herpes zoster infection. He presented with a 5-day history of proptosis and ptosis of the right eye that had been preceded by vesicular eruptions on the right forehead and scalp. Computed tomography scan of the head and orbit showed orbital abscess and right cavernous sinus thrombosis. A diagnosis of orbital abscess with SOFS secondary to herpes infection was made. The condition subsequently improved following antiviral therapy, intravenous vancomycin and amikacin, and oral corticosteroids. PMID:26632131

  18. Gallbladder Adenosquamous Carcinoma Associated with Biliopancreatic Maljunction and Cystic Metastases of the Liver Miming Abscess.

    PubMed

    Daldoul, Sami; Moussi, Amir

    2015-12-01

    Gallbladder adenosquamous carcinoma is a rare tumor with glandular and squamous malignant components. We report a special case of this rare tumor with cystic metastasis of the liver miming hepatic abscess and associated with biliopancreatic maljunction. PMID:27011570

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

    PubMed

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

    2016-01-25

    Idiopathic cecal ulcer is a rare disease entity of unknown cause diagnosed by ruling out other known causes of cecal ulceration. The most common complication of an idiopathic cecal ulcer is bleeding; perforation, peritonitis, abscess, and stricture formation have been noted. The authors treated a 53-year-old woman who presented with fever and intermittent right upper quadrant abdominal pain. Multiple pyogenic liver abscess and a solitary cecal ulcer were diagnosed by radiologic, endoscopic, and pathologic examination, followed by laparoscopic cecectomy. After extensive study, we concluded that this patient's liver abscesses were a complication of the idiopathic cecal ulcer. Herein, we report a case of multiple pyogenic liver abscess caused by microperforation of idiopathic cecal ulcer. PMID:26809632

  20. Tree-in-bud pattern of chest CT images for diagnosis of Mycobacterium abscesses

    PubMed Central

    Chu, Haiqing; Li, Bing; Zhao, Lan; Huang, Dongdong; Xu, Jinfu; Zhang, Jingbo; Gui, Tao; Xu, Liyun; Luo, Liulin; Zhang, Zhemin; Sun, Xiwen

    2015-01-01

    Objectives: Changes of chest CT images in Mycobacterium and non-Mycobacterium abscesses in patients with lung disease were with a view to making an early diagnosis. Methods: 124 primary patients diagnosed with non-tuberculosis Mycobacterium infections with a positive sputum acid-fast smear were enrolled in this retrospective study. CT images and clinical data of these patients were analyzed. Results: The 52 Mycobacterium abscess lung disease cases included bronchiectasis 82.7% (43/52), which was more easily detected bilaterally than unilaterally (29/52 vs. 14/52), lung consolidation 44.2% (23/52), nodules 44.2% (22/52), cavities 32.7% (17/52), tree-in-bud pattern 42.3% (22/52) and patchy shadow 63.5% (33/52) in CT images. Tree-in-bud pattern was more common in Mycobacterium abscess compared with non-Mycobacterium abscess lung disease (42.3% vs. 18.1%, P = 0.004). A significant difference of the lung area involved by tree-in-bud in CT was found between non-Mycobacteria abscess and Mycobacterium abscess lung disease (17.0% vs. 7.2%, P < 0.001), and tree-in-bud occurred more readily unilaterally (21.2% vs. 6.9%, P = 0.029), and in the inferior lobe of the right lung (3.2% vs. 0.2%, P = 0.029) in Mycobacterium abscess lung disease. Patchy shadow was more common in non-Mycobacterium abscess lung disease (63.5% vs. 80.1%, P = 0.041). Further multi-factor analysis confirmed that tree-in-bud was an independent predictor of Mycobacterium abscess lung disease. Conclusions: Different CT results existed between non-Mycobacterium abscess and Mycobacterium abscess lung diseases. The tree-in-bud pattern might be helpful to choose a suitable therapy in patients, with an acid-fast bacilli smear-positive diagnosis of lung disease. PMID:26770485

  1. Hepatic Abscess After Yttrium-90 Radioembolization for Islet-Cell Tumor Hepatic Metastasis

    SciTech Connect

    Mascarenhas, Neil B.; Mulcahy, Mary F.; Lewandowski, Robert J.; Salem, Riad; Ryu, Robert K.

    2010-06-15

    Infectious complications after yttrium-90 (y-90) radioembolization of hepatic tumors are rare. Most reports describe hepatic abscesses as complications of other locoregional therapies, such as transcatheter arterial embolization or chemoembolization. These usually occur in patients with a history of biliary intervention and present several weeks after treatment. We report a case of hepatic abscess formed immediately after y-90 radioembolization of a hepatic metastasis in a patient who had no history of previous biliary instrumentation.

  2. Ultrasound-guided diagnosis and aspiration of subdeltoid abscess from heroin injection.

    PubMed

    Clauson, Amanda; Mailhot, Tom; Chilstrom, Mikaela Lynn

    2014-11-01

    A 49-year-old man presented to the emergency department (ED) with shoulder pain after intramuscular injection of heroin into his right deltoid muscle. Point-of-care (POC) ultrasound identified a subdeltoid abscess, and ultrasound-guided aspiration of the fluid collection was performed. The patient was admitted and improved on antibiotics and made a complete recovery. POC ultrasound and ultrasound-guided aspiration can assist in the diagnosis and treatment of deep musculoskeletal abscesses. PMID:25493124

  3. An unusual case of lung abscess caused by Acremonium species treated with itraconazole.

    PubMed

    Qazi, M S; Bowalekar, S S; Wanjare, V S; Shankar, A

    2015-01-01

    We present a report of a 37-year-old female with lung abscess due to Acremonium species that responded to oral itraconazole. There was a marked clinical as well as radiological improvement in patient. To the best of our knowledge, this is the first case of lung abscess due to Acremonium species which was treated by oral itraconazole. This cost-effective treatment modality proved to be significant in improving symptoms as well as morbidity in this patient. PMID:25865993

  4. Endobronchial drainage of undiagnosed lung abscess during chest physical therapy. A case report.

    PubMed

    Räsänen, J; Bools, J C; Downs, J B

    1988-03-01

    Bronchial drainage, positive-pressure lung inflation, chest-wall percussion, and suctioning were performed in a patient with postoperative atelectasis, lung infection, and respiratory failure. A previously undiagnosed posterior lung abscess subsequently drained into the bronchial tree, causing dissemination of the infection and a severe deterioration of pulmonary function. Dissemination of pulmonary infection from a lung abscess is a possible complication that should be considered when prescribing and administering chest physical therapy. PMID:3347655

  5. Clinical characteristics of lung abscess in children: 15-year experience at two university hospitals

    PubMed Central

    Choi, Mi Suk; Chun, Ji Hye; Lee, Kyung Suk; Rha, Yeong Ho

    2015-01-01

    Purpose Information on the clinical features of lung abscess, which is uncommon in children, at hospitalizationis helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups. Methods The medical records of 11 lung abscess patients (7 males and 4 females) from March 1998 to August 2011 at two university hospitals were retrospectively reviewed. The clinical characteristics, symptoms, underlying disease, laboratory and radiologic findings, microbiological results, and treatments were examined. Results Six patients had underlying structural-related problems (e.g., skeletal anomalies). No immunologic or hematologic problem was recorded. The mean ages of the primary and secondary groups were 2.4 and 5.3 years, respectively, but the difference was not statistically significant. The mean length of hospital stay was similar in both groups (22.8 days vs. 21.4 days). Immunologic studies were performed in 3 patients; the results were within the normal range. Most patients had prominent leukocytosis. Seven and 4 patients had right and left lung abscess, respectively. Staphylococcus aureus, Streptococcus pneumoniae, and antimycoplasma antibodies were detected in both groups. Two patients with primary lung abscess were administered antibiotics in the absence of other procedures, while 8 underwent interventional procedures, including 5 with secondary abscess. Conclusion The most common symptoms were fever and cough. All patients in the primary group were younger than 3 years. Structural problems were dominant. Most patients required interventional procedures and antibiotics. PMID:26770223

  6. [Tubercular liver abscess: a case report and discussion of the literature].

    PubMed

    Bandrés, M P; Burstein, E; Casas, J; Verona, R

    1994-01-01

    A case of an isolated tuberculous abscess of the liver in a 47-years-old woman with a 2-year history of disease is presented. Only 17 similar cases have been reported previously in the literature. The symptomatology of this patient, confused initially with a chronic calculous cholecystitis and then with an hepatic pyogenic abscess exemplify what has been described for this rare disease presentation. A review of the pertinent literature is presented. PMID:8000027

  7. Localization of abscess in adult polycystic kidney by indium-111 leukocyte scan

    SciTech Connect

    Bretan, P.N. Jr.; Price, D.C.; McClure, R.D.

    1988-08-01

    In patients with adult polycystic kidney disease (APKD) infected cysts are difficult to localize with current radiographic techniques, especially those dependent on renal function. Indium-111 leukocyte (In-WBC) imaging is both highly sensitive and effective in detecting and localizing abscesses in patients with renal failure. We report on a patient with APKD and sepsis in whom computed tomography, ultrasound, and physical examination failed to locate the renal abscess, which was found by In-WBC scanning.

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

    PubMed Central

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

    2015-01-01

    First described by Sir Nicholas Brodie in 1832, Brodie's abscess is a localized subacute or chronic infection of the bone, typically seen in the metaphases of long bones in children and adolescents. The diagnosis can prove to be enigmatic due to absence of clinical signs and symptoms of systemic disease. We report a very interesting case of Brodie's abscess masquerading as sickle cell vasoocclusive crisis in a 20-year-old female with sickle cell disease and review the literature. PMID:26290668

  9. Co-incidental diagnosis of an extradural abscess while siting an extradural catheter for postoperative analgesia.

    PubMed

    Mercer, M; McIndoe, A

    1998-06-01

    Extradural abscess is a rare but serious complication of the extradural route of administration of analgesic drugs. We report a case of spontaneous extradural abscess diagnosed during placement of an extradural catheter for analgesia after a negative diagnostic laparotomy. Magnetic resonance imaging is the usual diagnostic tool of choice. This, and subsequent surgery, confirmed the diagnosis suspected after drainage of pus through the Tuohy needle. PMID:9771321

  10. Could Transgastric Endoscopic Ultrasound-Guided Aspiration Alone Be Effective for the Treatment of Pancreatic Abscesses?

    PubMed Central

    Jo, Hoon-Gil; Amarbat, Baatarnum; Jeong, Jin-Woo; Song, Hyo-Yeop; Song, Seung-Ryel

    2015-01-01

    Drainage of pancreatic abscesses is required for effective control of sepsis. Endoscopic ultrasound (EUS)-guided endoscopic drainage is less invasive than surgery and prevents local complications related to percutaneous drainage. Endoscopic drainage with stent placement in the uncinate process of the pancreas is a technically difficult procedure. We report a case of pancreatic abscess treated by repeated EUS-guided aspiration and intravenous antibiotics without an indwelling drainage catheter or surgical intervention. PMID:26240812

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

    PubMed

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

    2014-01-01

    Fusobacterium necrophorum is a Gram-negative anaerobic bacterium that causes foot rot and liver abscesses in cattle. F. necrophorum subsp. necrophorum and the less virulent organism F. necrophorum subsp. funduliforme are recognized. We present here a draft genome sequence of the bovine liver abscess isolate F. necrophorum subsp. funduliforme strain B35, which affords a genomic perspective of virulence and bovine adaptation. PMID:24786958

  12. Brain herniation

    MedlinePlus

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  13. Studies of the vivo uptake of Ga-67 by an experimental abscess: concise communication.

    PubMed

    Hayes, R L; Rafter, J J; Carlton, J E; Byrd, B L

    1982-01-01

    The blocking of Ga -67 plasma protein-binding sites-by administration of scandium citrate, ferric citrate, and a colloidal hydrous ferric oxide preparation-reduced the uptake of Ga-67 in normal soft tissues and also that in the viable portion of an experimental abscess. On the other hand, enhancement of Ga-67 plasma protein binding by administration of rabbit apotransferrin increased Ga-67 uptake in both abscess and normal soft tissues. These results indicate that the pathways of Ga-67 from blood into inflammatory processes and normal soft tissues may be similar. However, when Ga-67 plasma protein binding was increased by inducing anemia, a markedly decreased Ga-67 uptake in the abscess resulted, whereas uptake in normal soft tissue was still elevated. It is possible that the discrepancy between the effects of apotransferrin and anemia on abscess-tissue uptake of Ga-67 resulted from a secondary effect produced by anemia, i.e., a decrease in the macrophage population in the abscess. Taken as a whole, the results obtained suggest that Ga-67 leaves the blood and enters inflammatory lesions by pathways that are probably quite different from those in a soft-tissue tumor, and that the routes for abscesses may be similar to those occurring in normal soft tissues. PMID:6948092

  14. Studies of the in vivo uptake of Ga-67 by an experimental abscess: concise communication

    SciTech Connect

    Hayes, R.L.; Rafter, J.J.; Carlton, J.E.; Byrd, B.L.

    1982-01-01

    The blocking of Ga-67 plasma protein-binding sites--by administration of scandium citrate, ferric citrate, and a colloidal hydrous ferric oxide preparation--reduced the uptake of Ga-67 in normal soft tissues and also that in the viable portion of an experimental abscess. On the other hand, enhancement of Ga-67 plasma protein binding by administration of rabbit apotransferrin increased Ga-67 uptake in both abscess and normal soft tissues. These results indicate that the pathways of Ga-67 from blood into inflammatory processes and normal soft tissues may be similar. However, when Ga-67 plasma protein binding was increased by inducing anemia, a markedly decreased Ga-67 uptake in the abscess resulted, whereas uptake in normal soft tissue was still elevated. It is possible that the discrepancy between the effects of apotransferrin and anemia on abscess-tissue uptake of Ga-67 resulted from a secondary effect produced by anemia, i.e., a decrease in the macrophage population in the abscess. Taken as a whole, the results obtained suggest that Ga-67 leaves the blood and enters inflammatory lesions by pathways that are probably quite different from those in a soft-tissue tumor, and that the routes for abscesses may be similar to those occurring in normal soft tissues.

  15. Studies of the vivo uptake of Ga-67 by an experimental abscess: concise communication

    SciTech Connect

    Hayes, R.L.; Rafter, J.J.; Carlton, J.E.; Byrd, B.L.

    1982-01-01

    The blocking of Ga -67 plasma protein-binding sites-by administration of scandium citrate, ferric citrate, and a colloidal hydrous ferric oxide preparation-reduced the uptake of Ga-67 in normal soft tissues and also that in the viable portion of an experimental abscess. On the other hand, enhancement of Ga-67 plasma protein binding by administration of rabbit apotransferrin increased Ga-67 uptake in both abscess and normal soft tissues. These results indicate that the pathways of Ga-67 from blood into inflammatory processes and normal soft tissues may be similar. However, when Ga-67 plasma protein binding was increased by inducing anemia, a markedly decreased Ga-67 uptake in the abscess resulted, whereas uptake in normal soft tissue was still elevated. It is possible that the discrepancy between the effects of apotransferrin and anemia on abscess-tissue uptake of Ga-67 resulted from a secondary effect produced by anemia, i.e., a decrease in the macrophage population in the abscess. Taken as a whole, the results obtained suggest that Ga-67 leaves the blood and enters inflammatory lesions by pathways that are probably quite different from those in a soft-tissue tumor, and that the routes for abscesses may be similar to those occurring in normal soft tissues.

  16. High occurrence of perianal abscess among Bedouin compared to Jews in the southern region of Israel

    PubMed Central

    2013-01-01

    Background This study assessed the ethnic differences of perianal abscess between Bedouin and the general population in southern region of Israel. Israeli-born Arabs have much less colorectal cancer than Israeli-born Jews. It is not clear whether other colorectal diseases have the same ethnic occurrence. Method This is a retrospective case series of patients who had perianal abscess. Patients' demographics, managements and course of disease were analyzed. Results Bedouin male constituted 29.7% of all patients, while they constitute only 15.7% of the population relative risk of 2.27 (p< 0. 001). 16.4% of the patients experienced perianal abscess recurrence. 39% of the males with recurrent abscess formation were Bedouin, relative risk of 1.8 (p<0. 001). Conclusion Bedouin males have high relative risk to develop perianal abscess. Bedouin males as others with first recurrence have high relative risk for recurrence. Thus for both groups of patients, there is an indication to operate in order to treat the abscess and coexisting fistula. PMID:24028279

  17. Acute Bartholin's abscess: microbial spectrum, patient characteristics, clinical manifestation, and surgical outcomes.

    PubMed

    Krissi, H; Shmuely, A; Aviram, A; From, A; Edward, R; Peled, Y

    2016-03-01

    The purpose of this investigation was to evaluate the patient characteristics, clinical manifestations, microbiology, and modes of treatment of a large cohort of women with acute Bartholin's abscess, from a single medical center. A retrospective study was undertaken of all women diagnosed with acute Bartholin's gland abscess who were admitted to the gynecology department in a university-affiliated tertiary hospital in central Israel from January 2004 to December 2013. A total of 267 women were included in the study. The mean age at diagnosis was 33.5??12.1 years and the mean hospitalization period was 1.4??0.9days. Pain presented in 152 (56.9%), swelling in 81 (30.3%), and fever in 34 (12.7%). Leukocytosis was detected in 149 (55.8%). The three main treatment modalities were: antibiotics (75.7%), abscess drainage (19.1%), and marsupialization (80.9%). Bacterial infections were detected in 154 (57.7%) cultures, Escherichia coli presented in 59 (22.1%), and Streptococcus species in 27 (10.1%). The clinical and patient characteristics were similar between women with bacterial and sterile Bartholin's abscesses, though leukocytosis was more prevalent among women with bacterial infections. E. coli was the single most frequent pathogen in cultures of acute Bartholin's abscess. Respiratory tract-associated organisms were also common. This study indicates the polymicrobial spectrum of acute Bartholin's abscess. PMID:26740325

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

    PubMed

    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. PMID:25530161

  19. Nonoperative Management of a Multi-Regional Epidural Abscess with Neurological Dysfunction

    PubMed Central

    Hernandez, Miguel; Berg, Andrew; Bhatia, Chandra

    2015-01-01

    Spinal epidural abscesses are uncommon, but their incidence is increasing. They represent a collection of purulent material in the epidural space and most commonly occur in the lumbar spine, where they remain localised. Abscesses that affect all three spinal levels (holospinal or multiregional abscesses) are extremely rare, with only a few cases published in the literature. Epidural abscesses are particularly high risk infections as progressive neurological dysfunction can occur rapidly; early diagnosis and treatment is therefore essential to avoid long term neurological complications and reduce potential mortality. Given the uncommon nature of this condition, the treatment remains controversial with no definitive guidance on conservative versus surgical management. The literature mostly recommends surgical decompression along with intravenous antibiotics in patients with neurological abnormalities. We describe a case of a 77-year-old patient presenting with a delayed diagnosis of a multi-regional epidural abscess with associated upper motor neurone signs. The patient was successfully treated nonoperatively with a course of antibiotics resulting in complete radiological resolution of the abscess and full neurological recovery. PMID:26512341

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

    PubMed Central

    Cheng, Esther; Thorpe, Eric; Borrowdale, Richard

    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 patient recovered neurologic function after surgical decompression and drainage, long-term intravenous antibiotics, and physical therapy. Discussion The development of postoperative spinal epidural abscess is rare after otolaryngology procedures but has been reported in the cervical epidural space. To our knowledge, lumbar spinal epidural abscess has not yet been reported after head and neck oncologic surgery. Even more unique is the presence of the pathogen K. pneumoniae. Conclusion A high index of suspicion of this potential outcome is paramount as early recognition and intervention are keys to recovery of neurologic function. PMID:26799413

  1. Stripping out pus in lactational mastitis: a means of preventing breast abscess.

    PubMed Central

    Bertrand, H; Rosenblood, L K

    1991-01-01

    OBJECTIVE: To determine whether manual stripping of pus from the breasts of women with lactational mastitis is effective in preventing the formation of breast abscesses. DESIGN: Case series (chart review). SETTING: Family practice in Montreal. PATIENTS: All (475) charts of patients with lactational mastitis were reviewed; 61 women were excluded because they already had a breast abscess. Most of the patients had been referred. OUTCOME MEASURES: Abscess formation, length of illness after treatment, rate of recurrence of mastitis, illness in the mother or infant within the 6 weeks after the mastitis and continuance of breast-feeding. MAIN RESULTS: The duration of symptoms before treatment was 1 to 56 (mean 5.3) days. In 9% of the cases both breasts were affected, and in 23% at least one episode of mastitis had previously occurred. The stripping technique was applied to all the patients. Pus was removed in 210 women; the remaining women were considered to have cellulitis. Only four patients (less than 1%) had breast abscesses. The mean length of illness after treatment was 7.2 days. The rate of recurrence was 14%. In all, 6% of the mothers and 9% of the infants became ill in the 6 weeks after the mastitis. Most (92%) of the patients continued to breast-feed. CONCLUSIONS: The rate of abscess formation was considerably lower than the rates reported in the literature. Therefore, manual stripping of pus from the infected breasts of lactating women appears to be effective in preventing breast abscesses. PMID:1873763

  2. A Rare Case of Toxic Myocarditis Caused by Bacterial Liver Abscess Mimicking Acute Myocardial Infarction

    PubMed Central

    Zou, Yuhai; Lin, Lin; Xiao, Hua; Xiang, Dingcheng

    2016-01-01

    Patient: Male, 66 Final Diagnosis: Toxic myocarditis Symptoms: — Medication: — Clinical Procedure: Emergency Specialty: Cardiology Objective: Rare disease Background: Chills, high fever, right upper abdomen pain, and increased white blood cell count are the main and common clinical features of bacterial liver abscess. It is rare to see bacterial liver abscess present symptoms of myocardial injury first, and this can lead to misdiagnosis. Case Report: We report a case of toxic myocarditis caused by bacterial liver abscess. The patient first presented with chest pain, ST segment elevation, and elevated TNI, which misled us to diagnose myocardial infarction, but the coronary artery had no stenosis or obstructive lesions after emergency coronary angiography. Then we modified the diagnosis to toxic myocarditis. Bacterial liver abscess was the proposed etiology after a series of auxiliary examinations. Finally, antibiotics and percutaneous liver puncture catheter drainage were used to improve the clinical outcome. Conclusions: It is rare that patients with bacterial liver abscess first present symptoms of myocardial injury. Differential diagnosis between myocarditis and myocardial infarction should be careful, as myocarditis is a diagnosis of exclusion, and coronary angiography is necessary to confirm coronary disease. Percutaneous liver puncture catheter drainage can effectively cure bacterial liver abscess. PMID:26726772

  3. A Rare Case of Toxic Myocarditis Caused by Bacterial Liver Abscess Mimicking Acute Myocardial Infarction.

    PubMed

    Zou, Yuhai; Lin, Lin; Xiao, Hua; Xiang, Dingcheng

    2016-01-01

    BACKGROUND Chills, high fever, right upper abdomen pain, and increased white blood cell count are the main and common clinical features of bacterial liver abscess. It is rare to see bacterial liver abscess present symptoms of myocardial injury first, and this can lead to misdiagnosis. CASE REPORT We report a case of toxic myocarditis caused by bacterial liver abscess. The patient first presented with chest pain, ST segment elevation, and elevated TNI, which misled us to diagnose myocardial infarction, but the coronary artery had no stenosis or obstructive lesions after emergency coronary angiography. Then we modified the diagnosis to toxic myocarditis. Bacterial liver abscess was the proposed etiology after a series of auxiliary examinations. Finally, antibiotics and percutaneous liver puncture catheter drainage were used to improve the clinical outcome. CONCLUSIONS It is rare that patients with bacterial liver abscess first present symptoms of myocardial injury. Differential diagnosis between myocarditis and myocardial infarction should be careful, as myocarditis is a diagnosis of exclusion, and coronary angiography is necessary to confirm coronary disease. Percutaneous liver puncture catheter drainage can effectively cure bacterial liver abscess. PMID:26726772

  4. Gallbladder Cancer Presenting with Brain and Bone Metastasis: Case Report

    PubMed Central

    Singh, Manish; Karmakar, Shilpi; Karmakar, Saurabh

    2015-01-01

    Although gallbladder cancer is a rare disease worldwide, north India has one of the highest incidences of this disease. We report a case of asymptomatic gall bladder cancer with brain metastasis. The patient presented with a scalp lump as the sole presenting feature, with no symptoms attributable to abdominal malignancy. Previously, the lump had been incised by a local practitioner who had probably misdiagnosed it as an abscess. PMID:25954661

  5. Left Colon Diverticulitis Presenting as Perforated Lumbar Abscess: A Case Report and Review of the Current Literature

    PubMed Central

    Paramythiotis, Daniel; Kofina, Konstantinia; Papadopoulos, Vassileios N.; Michalopoulos, Antonios

    2015-01-01

    Diverticular perforation is a common complication of diverticulitis and can lead to the creation of abscesses. The presence of such abscesses on the abdominal wall is rare and can lead to misdiagnosis. We present the case of a patient with abdominal pain and the formation of a large left lumbar abscess due to perforation of a diverticulum of the left colon and our surgical treatment of choice with favorable results. PMID:26881151

  6. Treatment of Prostatic Abscess: Case Collection and Comparison of Treatment Methods

    PubMed Central

    Jang, Kidon; Lee, Dae Hun; Chung, Byung Ha

    2012-01-01

    Purpose Prostatic abscess is an uncommon urologic disease but has a high mortality rate if not treated properly. Furthermore, diagnosis and proper treatment of prostatic abscesses remains a challenge for physicians. Therefore, we compared data on conservative treatments, transurethral resection of prostatic abscess, and transrectal ultrasound (TRUS)-guided needle aspiration in 52 cases over a 10-year period. Materials and Methods The records of 52 patients diagnosed with prostatic abscess by computed tomography at Gangnam Severance Hospital between January 2000 and September 2010 were retrospectively reviewed. All patients were discharged when their leukocytosis had normalized and they had been free of fever for 2 days. Multivariate regression analysis was done to determine independent risk factors for the length of hospitalization. Results At the time of diagnosis, the average age of the 52 patients was 61.3 years (range, 33 to 81 years), the average volume of the prostate was 56.3 ml (range, 21 to 223 ml), the average prostate-specific antigen was 18.54 ng/ml (range, 2.0 to 57.0 ng/ml), and the average abscess size was 3.8 cm (range, 2.1 to 5.5 cm). All patients were treated with parenteral antibiotics during their hospital stay with intravenous antibiotics (fluoroquinolone monotherapy or 3rd-generation cephalosporin in combination with an aminoglycoside). Of 52 patients, 22 had diabetes mellitus (42.3%), 19 had hypertension (36.5%), and 7 (13.5%) had paraplegia due to spinal cord injury. The most common symptoms were fever (47, 90.4%), perineal discomfort (43, 82.7%), dysuria (40, 76.9%), and urinary retention (29, 55.8%). Prostatic abscesses were treated by conservative treatment (11 cases), transurethral resection of prostatic abscess (23 cases), and TRUS-guided needle aspiration (18 cases). The average hospitalization stay was 17.5 days (range, 6 to 39 days); that of conservative treatment patients was 19.1 days (range, 9 to 39 days). Patients treated by transurethral resection of prostatic abscess and TRUS-guided needle aspiration stayed 10.2 days (range, 6 to 15 days) and 23.25 days (range, 18 to 34 days), respectively. Of the 18 cases who underwent needle aspiration, prostatic abscesses recurred in 4 cases (22.2%) within 1 month after patient discharge. The 2 patients subjected to conservative treatment died due to sepsis. We found no independent factors that affected the average hospitalization period. Conclusions Patients with prostatic abscess treated by transurethral resection of the prostate had a significantly shorter hospitalization length compared with needle aspiration. PMID:23301131

  7. Novel use of a radiolabelled antibody against stage specific embryonic antigen for the detection of occult abscesses in mammals

    DOEpatents

    Thakur, Madhukar L.

    1990-01-01

    The invention discloses improved reagents containing antibodies against stage specific embryonic antigen-1 antibodies and improved methods for detection of occult abscess and inflammation using the improved reagents.

  8. Spontaneous fistulisation and drainage of a pyogenic liver abscess into the stomach in an adult patient with sickle cell disease.

    PubMed

    Islam, Shariful; Hosein, Devin; Bheem, Vinoo; Harnarayan, Patrick

    2016-01-01

    Spontaneous endoluminal drainage of a pyogenic liver abscess is a rare phenomenon. Similarly, there are only a few cases in the English literature describing hepatic abscesses as an unusual complication of sickle cell anaemia. Having these two phenomena occurring in the same patient is truly a rarity. We describe a case of a 45-year-old man with homozygous sickle cell anaemia who presented to our institution with a pyogenic liver abscess. He had spontaneous drainage of the abscess after spontaneous fistulisation, with the stomach obviating the need for percutaneous drainage. PMID:26976835

  9. Ultrasonography and determination of proteins and enzymes in blood for the diagnosis of liver abscesses in intensively fed beef cattle.

    PubMed

    Liberg, P; Jönsson, G

    1993-01-01

    The concentrations of plasma proteins and the activities of liver enzymes were measured every 2 weeks from weaning to slaughter in 21 beef cattle, and their livers were examined ultrasonographically every 4 weeks. Eight of the 9 cases of single or multiple liver abscesses were detected by ultrasonography but some individual abscesses, particularly those in the left side of the liver, remained undetected. The time at which the abscesses were first detected ranged from 4 to 20 (mean 12.5) weeks. There were only slight variations in the blood constituents and they were of no significant value in the diagnosis of the liver abscesses. PMID:8102027

  10. Nomogram Estimating the Probability of Intraabdominal Abscesses after Gastrectomy in Patients with Gastric Cancer

    PubMed Central

    Eom, Bang Wool; Joo, Jungnam; Park, Boram; Yoon, Hong Man; Ryu, Keun Won; Kim, Soo Jin

    2015-01-01

    Purpose Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period. Materials and Methods We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets. Results The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess. Conclusions This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge. PMID:26816657

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

    PubMed Central

    Hadithi, Muhammed; Bruno, Marco J

    2014-01-01

    AIM: To show the safety and effectiveness of endoscopic ultrasound (EUS)-guided drainage of pelvic abscess that were inaccessible for percutaneous drainage. METHODS: Eight consecutive patients with pelvic abscess that were not amenable to drainage under computed tomography (CT) guidance were referred for EUS-guided drainage. The underlying cause of the abscesses included diverticulitis in 4, postsurgical surgical complications in 2, iatrogenic after enema in 1, and Crohns disease in 1 patient. Abscesses were all drained under EUS guidance via a transrectal or transsigmoidal approach. RESULTS: EUS-guided placement of one or two 7 Fr pigtail stents was technically successful and uneventful in all 8 patients (100%). The abscess was perisigmoidal in 2 and was multilocular in 4 patients. All procedures were performed under conscious sedation and without fluoroscopic monitoring. Fluid samples were successfully retrieved for microbiological studies in all cases and antibiotic policy was adjusted according to culture results in 5 patients. Follow-up CT showed complete recovery and disappearance of abscess. The stents were retrieved by sigmoidoscopy in only two patients and had spontaneously migrated to outside in six patients. All drainage procedures resulted in a favourable clinical outcome. All patients became afebrile within 24 h after drainage and the mean duration of the postprocedure hospital stay was 8 d (range 4-14). Within a median follow up period of 38 mo (range 12-52) no recurrence was reported. CONCLUSION: We conclude that EUS-guided drainage of pelvic abscesses without fluoroscopic monitoring is a minimally invasive, safe and effective approach that should be considered in selected patients. PMID:25132921

  12. Effect of Fusobacterium necrophorum leukotoxoid vaccine on susceptibility to experimentally induced liver abscesses in cattle.

    PubMed

    Saginala, S; Nagaraja, T G; Lechtenberg, K F; Chengappa, M M; Kemp, K E; Hine, P M

    1997-04-01

    The efficacy and the optimum dose of Fusobacterium necrophorum crude leukotoxoid vaccine required to immunize and protect steers against experimentally induced liver abscesses were evaluated. The vaccine consisted of cell-free culture supernatant of a high leukotoxin-producing strain of F. necrophorum, inactivated with formalin and homogenized with an adjuvant. Twenty-five steers were assigned randomly to the following five treatment groups: control; three doses (1.0, 2.0, and 5.0 mL) of the culture supernatant; and 2.25 mL of the concentrated supernatant (equivalent to 5 mL of the original supernatant). Vaccine was injected subcutaneously on d 0 and 21. Blood samples were collected weekly to monitor antileukotoxin antibody titers. Three weeks after the second vaccination (d 42), all steers were injected intraportally with F. necrophorum culture to induce liver abscesses. Three weeks later (d 63), steers were euthanatized and necropsied; livers were examined and protection assessed. Antileukotoxin antibody titers in the control steers generally did not differ from the baseline (wk 0) titers. The titers in the vaccinated groups increased, more so after the second injection, and the increase was generally dose-dependent. Necropsy examination revealed that all steers in the control group had abscesses in the liver. In the vaccinated groups, two of five steers in the 1.0-mL group and one each in the 2.0-, 5.0-, and 2.25-mL (concentrated) groups had liver abscesses. Antileukotoxin antibody titers were higher (P < .05) in steers that did not develop abscesses than in steers that developed abscesses. The difference suggested a protective effect of antileukotoxin antibodies against experimentally induced liver abscesses. PMID:9110232

  13. Bacterial flora of liver abscesses in feedlot cattle fed tylosin or no tylosin.

    PubMed

    Nagaraja, T G; Beharka, A B; Chengappa, M M; Carroll, L H; Raun, A P; Laudert, S B; Parrott, J C

    1999-04-01

    Bacterial flora of liver abscesses from cattle fed tylosin or no tylosin and susceptibilities of the predominant bacterial isolates to tylosin and other antimicrobial compounds were determined. Abscessed livers were collected at slaughter from cattle originating from feedlots that had fed tylosin (n = 36) or no tylosin (n = 41) for at least 2 yr, and segments of livers with one or two intact abscesses were transported to the laboratory. Abscesses were cultured for anaerobic and facultative bacteria. Fusobacterium necrophorum, either as single culture or mixed with other bacteria, was isolated from all abscesses. The incidence of subsp. necrophorum, as part of the mixed infection, was lower (P < .05) in the tylosin group than in the no-tylosin group (33 vs 61%). However, the incidence of Actinomyces pyogenes was higher (P < .01) in the tylosin group than in the no-tylosin group (53 vs 10%). Totals of 119 F. necrophorum and 21 A. pyogenes isolates were used for determinations of susceptibilities to bacitracin, oxytetracycline, chlortetracycline, lasalocid, monensin, tylosin, tilmicosin, and virginiamycin. The minimum inhibitory concentrations (MIC) of antibiotics were determined with a broth microdilution method. The mean MIC of tylosin for F. necrophorum and A. pyogenes were not different between isolates from tylosin and no-tylosin groups. We concluded that continuous feeding of tylosin did not induce resistance in F. necrophorum or A. pyogenes. Also, the higher incidence of mixed infection of F. necrophorum and A. pyogenes in liver abscesses of tylosin-fed cattle suggests a potential synergistic interaction between the two organisms in causing liver abscesses. PMID:10328365

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

    PubMed

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

    2016-05-01

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

  15. [Klebsiella pneumoniae meningitis associated with liver abscess: a case report].

    PubMed

    Yanagawa, T; Nakamura, H; Takei, I; Maruyama, H; Kataoka, K; Saruta, T; Kobayashi, Y

    1989-10-01

    We report a rare case of Klebsiella pneumoniae meningitis associated with liver abscess, which was successfully treated with cefotaxime (CTX), one of the third-generation cephalosporins. A 53-year-old man was admitted to Keio University Hospital on June 13, 1988, because of a fever and a headache. On June 3, he suddenly started shivering and his temperature rose to 39 degrees C. He then began to complain of polydipsia, polyuria, and a weight loss of 4 kg a week. On June 11, he developed a severe headache. Four years prior to this incident, he had been diagnosed as having diabetes after a routine medical examination, but had neglected to undergo medical treatment. On admission, laboratory data showed leukocytosis, hyperglycemia (394 mg/dl) and ketonuria (4+). A lumbar puncture yielded cloudy cerebrospinal fluid (CSF) containing 500/3 cells/mm8, of which about 70% were neutrophils. A diagnosis of diabetic ketoacidosis and purulent meningitis was made. A treatment with ampicillin (ABPC) and CTX, (12 g/day, each) was begun. On the third day, cultures of a blood specimen and CSF yielded both K. pneumoniae. The MICs of CTX to K. pneumoniae isolated from blood and CSF were both 0.05 microgram/ml. ABPC was discontinued, gentamicin was administered for 2 days, CTX was continued at the same dosage level and an administration of prednisolone 40 mg daily was begun.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2691713

  16. Mycobacterium abscessus cording prevents phagocytosis and promotes abscess formation.

    PubMed

    Bernut, Audrey; Herrmann, Jean-Louis; Kissa, Karima; Dubremetz, Jean-François; Gaillard, Jean-Louis; Lutfalla, Georges; Kremer, Laurent

    2014-03-11

    Mycobacterium abscessus is a rapidly growing Mycobacterium causing a wide spectrum of clinical syndromes. It now is recognized as a pulmonary pathogen to which cystic fibrosis patients have a particular susceptibility. The M. abscessus rough (R) variant, devoid of cell-surface glycopeptidolipids (GPLs), causes more severe clinical disease than the smooth (S) variant, but the underlying mechanisms of R-variant virulence remain obscure. Exploiting the optical transparency of zebrafish embryos, we observed that the increased virulence of the M. abscessus R variant compared with the S variant correlated with the loss of GPL production. The virulence of the R variant involved the massive production of serpentine cords, absent during S-variant infection, and the cords initiated abscess formation leading to rapid larval death. Cording occurred within the vasculature and was highly pronounced in the central nervous system (CNS). It appears that M. abscessus is transported to the CNS within macrophages. The release of M. abscessus from apoptotic macrophages initiated the formation of cords that grew too large to be phagocytized by macrophages or neutrophils. This study is a description of the crucial role of cording in the in vivo physiopathology of M. abscessus infection and emphasizes cording as a mechanism of immune evasion. PMID:24567393

  17. Renal tuberculosis and iliopsoas abscess: Two case reports

    PubMed Central

    WEI, HONG-LAN; WANG, LEI; DU, XING-GUO; WU, YANG; LI, HUA; CAI, YUAN; SONG, XIAO-HONG; LI, CHENG-XU; DONG, LI-PING; LIU, ZHI-FEN; ZHAO, XIA; DONG, JUN-WU

    2014-01-01

    The urinary system is the second most commonly affected site of extrapulmonary tuberculosis (TB). Due to the diverse and atypical clinical manifestations of urinary TB, the disease is easy to misdiagnose. In the present study, two cases of renal TB are reported, which had completely different clinical manifestations. The first case is a female who presented with loin pain and fever. Purified protein derivative (PPD) and TB antibody tests were negative and computed tomography (CT) scans showed a low density focus in the right kidney with an iliopsoas abscess. The typical CT findings indicated renal tuberculosis. Anti-TB drugs were effective proved the diagnosis. The second case is a male who presented with intermittent gross hematuria. Acid-fast bacilli in urine and TB antibody tests were positive. CT scans revealed a low density focus in the unilateral kidney with a slight expansion of the pelvis, calices and ureter. The patients were treated with the anti-TB drugs and the clinical manifestations disappeared. The diagnosis of urinary TB is challenging in certain cases; when there is no response to the usual antibiotics in patients with fever or gross hematuria, TB should be suspected. CT is the mainstay for investigating possible urinary TB. PMID:24926373

  18. [Fever and lung abscesses in anorexia nervosa after infusion therapy].

    PubMed

    Hoffmann, J; Herzum, M; Maisch, B

    1994-06-01

    A 26 year old female patient was admitted to our hospital because of septic temperatures and chills. In the patient's history renal insufficiency has been known for several years due to agenesia of the right and pyelonephritic renal congestion of the left kidney. Long lasting anorexia nervosa had been treated by psychotherapeutical interventions for years and when failing it necessitated repeated intravenous nutrition by central venous lines. The prominent symptom of the intravenously treated young woman was fever up to 39.7 degrees C and pneumonia, which was considered by the first treating clinic to be caused directly by diminished immunoreactivity in malnutrition and preuremia. The chest X-ray confirmed pneumonia and revealed multiple abscesses in both lungs (Figure 1). After being transferred to our intensive care unit the pathophysiological context became obvious. From inspection (positive jugular pulsation), from auscultation (holosystolic murmur at the left parasternal border) tricuspid incompetence due to infective endocarditis was suspected. This was confirmed immediately by TM and two-dimensional transthoracic echocardiography, which showed a large vegetation on the anterior tricuspid valve leaflet (Figures 2a and 2b). Tricuspid regurgitation was also ascertained by color flow echocardiography (Figure 2c). Several blood cultures were positive for staphylococcus aureus. Clinical and laboratory recovery was achieved by antibiotic therapy with vancomycin and cephtazidim for 3 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7927123

  19. A para-canalicular abscess resembling an inflamed chalazion.

    PubMed

    Almaliotis, Diamantis; Nakos, Elias; Siempis, Thomas; Koletsa, Triantafyllia; Kostopoulos, Ioannis; Chatzipantazi, Maria; Karampatakis, Vasileios

    2013-01-01

    Background. Lacrimal infections by Actinomyces are rare and commonly misdiagnosed for long periods of time. They account for 2% of all lacrimal diseases. Case Report. We report a case of a 70-year-old female patient suffering from a para-canalicular abscess in the medial canthus of the left eye, beside the lower punctum lacrimale, resembling a chalazion. Purulence exited from the punctum lacrimale due to inflammation of the inferior canaliculus (canaliculitis). When pressure was applied to the mass, a second exit of purulence was also observed under the palpebral conjunctiva below the lacrimal caruncle. A surgical excision was performed followed by administration of local antibiotic therapy. The histopathological examination of the extracted mass revealed the existence of actinomycosis. Conclusion. Persistent or recurrent infections and lumps of the eyelids should be thoroughly investigated. Actinomyces as a causative agent should be considered. Differential diagnosis is broad and should include canaliculitis, chalazion, and multiple types of neoplasias. For this reason, in nonconclusive cases, a histopathological examination should be performed. PMID:23762696

  20. [3 cases of hematogenous lung abscess of amebic origin].

    PubMed

    García Uribe, J A; Padua Gabriel, A; Quintana, O; García Vázquez, A; de la Escosura, G

    1991-01-01

    Invasive amebiasis is a very serious health problem in Mexico as it is presumably related to the presence of virulent strains of Entamoeba histolytica and poor hygienic and sanitary conditions; other factors related to invasive amebiasis are undernutrition, alcoholism, and homosexuality. We present three patients with pulmonary amebic hematogenous abscess. Clinically all patients had the typical "chocolate" exudate. The three patients had pulmonary consolidations by chest roentgenogram; one of them had multiple opacities with air fluid level, and the others had an isolated opacity with air fluid level. The ultrasound and hepatogammagram were negative for diaphragmatic communication in all; in one of them the pneumoperitoneum was negative for diaphragmatic communication. The transthoracic needle biopsy of the lesions was positive to ameba in two patients. The serologic tests were positive in all. We treated the patients with metronidazole and emetine during 10 days; since the clinical picture and the radiologic findings did not remit completely, we gave a second course of metronidazole during 10 days more and achieved complete resolution. PMID:1818373