Note: This page contains sample records for the topic gas-forming brain abscess from
While these samples are representative of the content of,
they are not comprehensive nor are they the most current set.
We encourage you to perform a real-time search of
to obtain the most current and comprehensive results.
Last update: November 12, 2013.

Brain abscess.  


A brain abscess is defined as a localized collection of pus within the parenchyma of the brain or meninges. Brain abscesses are a complication of ear, sinus, and/or dental infections. Although they may occur in many brain locations, the most common sites are frontal and temporal lobes. Modern neuroimaging and laboratory analysis have led to prompt diagnosis and have decreased the mortality rates from brain abscess. Critical care nurses have a vital role in performing accurate neurologic assessments, timely administration of antibiotics, and management of fever. PMID:23981454

Slazinski, Tess



Brain Abscess  


... HIV by not having sex or practicing safe sex. Treatment Treatment of a brain abscess typically requires a two-pronged approach: Treating ... 9397, 31073, 31158, brain ... resonance imaging,mri,muscle weakness,nausea,sex


Brain abscess  


... the body during an injury (such as a gun or knife wound) or neurosurgery. In children with ... to diagnose a brain abscess may include: Blood cultures Chest x-ray Complete blood count ( CBC ) Head ...


Immunopathogenesis of brain abscess  

Microsoft Academic Search

Brain abscess represents a significant medical problem despite recent advances made in detection and therapy. Due to the emergence of multi-drug resistant strains and the ubiquitous nature of bacteria, the occurrence of brain abscess is likely to persist. Our laboratory has developed a mouse experimental brain abscess model allowing for the identification of key mediators in the CNS anti-bacterial immune

Tammy Kielian



An intradural-extramedullary gas-forming spinal abscess in a patient with diabetes mellitus.  


Spinal infections are commonly reported to be located in the extradural or intramedullary spaces. Infection involving the intradural-extramedullary space are uncommon. We report a patient with uncontrolled diabetes mellitus and an infected foot ulcer who presented with a cervical cord abscess and intradural gas. Early diagnosis and aggressive treatment are necessary for a favourable outcome in gas-forming intradural spinal abscesses. To our knowledge, a gas-forming intradural spinal abscess has not been reported previously and we discuss the relevant literature. PMID:20036548

Nadkarni, Trimurti; Shah, Abhidha; Kansal, Ritesh; Goel, Atul



Brain abscess in children  

Microsoft Academic Search

Objectives: Brain abscess is a serious life-threatening complication of several diseases. The objective of this study was to look at\\u000a the clinical profile of patients, predisposing conditions, microbiology and outcome of children suffering from brain abscess.Methods: Thirty children aged less than 15 years were reviewed. There were 15 males and 15 females. The mean age of presentation\\u000a was 5.6±4.4 years.Results:

Mehnaz Atiq; Umair Syed Ahmed; Salman Saleem Allana; Khalid N. Chishti




PubMed Central

A fifty year old man presented to a psychiatric unit with catatonia. He was later found to have a brain abscess in the left frontal region. Brain abscess has not been previously reported to be associated with catatonia.

Davis, Elizabeth J.B.; Borde, Milind; Davis, Rachel



Brain abscess: Current management  

PubMed Central

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.

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



Aspergillus brain abscess.  


Aspergillus brain abscess is a rare clinical entity, which remains a challenge to diagnose and treat. Most fungi are low virulence organisms, often living as commensals. They however, pose a considerable challenge in an immune-compromised host. Systemic steroids are commonly used in treatment of various inflammatory conditions. Despite their relatively safe profile, one peril of such treatment is immune suppression. It is prudent that physicians remain aware of the risk of various opportunistic infections in such patients. We present a case of fatal intra-cranial aspergillosis in an immuno-compromised patient on systemic steroids. PMID:24015447

Bhaskar, Nutan; Mohammad, Khalid; Kaur, Varinder



Pyogenic brain abscess, a 15 year survey  

PubMed Central

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



Brain abscess caused by Nocardia nova  

Microsoft Academic Search

Nocardia nova is a newly identified species of the Nocardia asteroides group and has recently been characterized as a human pathogen. To date, a few cases of N. nova pneumonia or subcutaneous abscess have been reported. We describe a patient with a brain abscess caused by N. nova in a patient receiving prednisolone and cyclophosphamide for nephrosis. Surgical excision and

Mizuki Hashimoto; Ken Johkura; Teruo Ichikawa; Masamichi Shinonaga



A Pneumococcal Brain Abscess: A Case Report  

PubMed Central

A brain abscess which is caused by Streptococcus pneumoniae is a rare entity. Here, we have described a gentle man who presented with the signs and symptoms of a mass lesion which was localized to the temporal lobe. The clinical examination and computerized tomography revealed the diagnosis of a temporal abscess. The loculated mass was tapped and it was sent for histopathology, which confirmed the presence of an organizing abscess. A laboratory investigation of the pus revealed Streptococcus pneumoniae. The treatment included total excision and the administration of prolonged antibiotics, which led to a good outcome in the patient.

Belodu, Rashmi; S., Nagarathna; R., Ravikumar; Kumar, Rakesh; B.A., Chandramouli



Endoscopic treatment of brain abscesses  

Microsoft Academic Search

Background  Stereotactic aspiration with external drainage has become widely accepted as the standard treatment for intracerebral abscesses. Although neuroendoscopic technique has only been occasionally adopted for this pathology, it introduces some advantages because it presents visual awareness that the pus has been removed.Methods  Four patients with cerebral abscess and one with a subdural empyema were operated using a neuroendoscopic technique in our

P. Longatti; A. Perin; F. Ettorre; A. Fiorindi; V. Baratto



Inflammatory index and treatment of brain abscess.  


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

Oyama, Hirofumi; Kito, Akira; Maki, Hideki; Hattori, Kenichi; Noda, Tomoyuki; Wada, Kentaro



Management and outcome of brain abscess in renal transplant recipients  

Microsoft Academic Search

Although infection is the commonest central nervous system complication following renal transplantation, brain abscess is uncommon. Over the last 11 years, five renal transplant recipients who had brain abscesses were treated by computed tomography (CT)-guided stereotactic aspiration. Three patients had a fungal abscess, one a tuberculous abscess and the other had a methicillin-resistantStaphylococcus aureus abscess. One patient required a craniotomy

M J Arunkumar; Vedantam Rajshekhar; Mathew J Chandy; Paulose P Thomas; Chacko Korula Jacob



Postneurosurgical Nosocomial Bacterial Brain Abscess in Adults  

Microsoft Academic Search

Background:  Bacterial brain abscess after a neurosurgical procedure has become an important occurrence in the hospital setting. However,\\u000a no information about the frequency, clinical relevance, and the outcome has been reported.\\u000a \\u000a \\u000a \\u000a Patients and Methods:  Over a period of 19 years (1986– 2004), a total of 31 patients were retrospectively identified as having brain abscesses after\\u000a neurosurgical procedures and were enrolled in this

K.-Y. Yang; W.-N. Chang; J.-T. Ho; H.-C. Wang; C.-H. Lu



Brain-abscess caused by Streptococcus bovis  

Microsoft Academic Search

Sir, Streptococcusbovis is found in the faeces of10-16 % of healthy persons and animals (i). This causative agent has long been known to be associated with endocarditis (2). It is a frequent cause of bacteremia and gastrointestinal diseases, principally neoplasias of the colon (1). We report a case of brain abscess associated with endocarditis caused by Streptococcus bovis. A 69

M. Montejo Baranda; K. Aguirrebengoa; M. Testillano; C. Aguirre



Brain abscess due to Streptococcus MG-intermedius (Streptococcus milleri).  

PubMed Central

Three cases of brain abscesses due to Streptococcus MG-intermedius are reported, and the literature pertaining to this subject is reviewed. The importance of careful and complete identification of these etiological agents of infection is stressed. The clinical presentation, the origin of S. MG-intermedius producing brain abscess, and its relation to hepatic abscesses and endocarditis are discussed.

Melo, J C; Raff, M J



Stereotactic surgery in the management of brain abscess  

Microsoft Academic Search

BACKGROUNDBacterial brain abscesses can be diagnosed and treated with stereotactic aspiration.METHODSFrom 1991 to 1997 we have used computed tomography-guided stereotactic aspiration to diagnose and treat 21 patients with a total of 58 bacterial brain abscesses. The ages of the patients ranged from 4 to 72 years (median 25 years); 11 of these 21 patients had multiple abscesses. The number of

Orhan Barlas; Altay Sencer; Kaan Erkan; Haluk Eraksoy; Serra Sencer; Çiçek Bayindir



Fatal Aspergillus brain abscess in immunocompetent patient  

Microsoft Academic Search

Intracranial aspergillosis is a rare pathologic condition, difficult to treat and often fatal which generally affects immunocompromised\\u000a hosts. High-dose steroid therapy represents a risk factor for opportunistic infections. We report a case of fatal brain abscess\\u000a in an immunocompetent patient with a previous diagnosis of acute disseminated encephalomyelitis (ADEM) in whom a high-dose\\u000a steroid course has probably contributed to the

Marcella Curone; Domenico D’Amico; Elio Maccagnano; Gennaro Bussone



Brain abscess in a recent immigrant.  


A 7-year-old boy who has recently immigrated from India presented with two episodes of focal seizure over a 3-month period. A cranial magnetic resonance imaging scan showed a ring-enhancing lesion in his cerebral cortex. He was diagnosed with a pyogenic brain abscess following resection of the lesion and also had positive serology to Taenia solium (which causes neurocysticercosis). We briefly review these two diseases and discuss the important diagnostic issues. PMID:23252509

Britton, Philip N; Chaseling, Raymond



Neurosurgical management of brain abscesses in children  

Microsoft Academic Search

The authors review the management of brain abscesses (BAbs) in 59 pediatric cases. The major surgical procedure used to treat\\u000a them was repeated puncture and aspiration (51 cases, or 86.44%), excision (8 cases – 13.56%) being of secondary importance.\\u000a The main etiology was metastatic lesions (24 cases – 40.68%), those due to cyanotic congenital heart disease being the most\\u000a frequent.

A. V. Ciurea; F. Stoica; G. Vasilescu; L. Nuteanu



Management and outcome of brain abscess in renal transplant recipients  

PubMed Central

Although infection is the commonest central nervous system complication following renal transplantation, brain abscess is uncommon. Over the last 11 years, five renal transplant recipients who had brain abscesses were treated by computed tomography (CT)-guided stereotactic aspiration. Three patients had a fungal abscess, one a tuberculous abscess and the other had a methicillin-resistant Staphylococcus aureus abscess. One patient required a craniotomy for the excision of a fungal abscess which was persistent after two CT-guided stereotactic aspirations. The survivors in this group are the patient with a tuberculous abscess who is alive and well 5 years after diagnosis, and another with a dematiaceous fungal abscess (phaeohyphomycosis). CT-guided stereotactic surgery is minimally invasive, and can safely be performed in these patients. It often leads to an aetiological diagnosis in renal transplant recipients with brain abscesses. Specific antibiotic management directed towards the causative organism rather than empirical treatment can be instituted following the procedure. Although the ultimate prognosis in these patients is bleak even with specific antibiotic therapy, an occasional patient might have a good outcome with prompt and appropriate therapy.???Keywords: brain abscess; computed tomography guided stereotaxy; renal transplant recipients

Arunkumar, M; Rajshekhar, V.; Chandy, M.; Thomas, P.; Jacob, C. K.



Positive indium-111 leukocyte scan in Nocardia brain abscess  

SciTech Connect

We report a case of clinically unsuspected nocardia brain abscess detected by /sup 111/In-labeled autologous leukocytes. Clinical and computed tomographic findings supported the diagnosis of primary or metastatic tumor and the patient was treated with dexamethasone for 30 days prior to the leukocyte scan. Labeled leukocytes may provide a sensitive discriminator for brain abscess despite previous therapy with steroids.

Bauman, J.M.; Osenbach, R.; Hartshorne, M.F.; Youngblood, L.; Crooks, L.; Landry, A.J.; Cawthon, M.A.



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

PubMed Central

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



Management and outcome of brain abscess in renal transplant recipients.  


Although infection is the commonest central nervous system complication following renal transplantation, brain abscess is uncommon. Over the last 11 years, five renal transplant recipients who had brain abscesses were treated by computed tomography (CT)-guided stereotactic aspiration. Three patients had a fungal abscess, one a tuberculous abscess and the other had a methicillin-resistant Staphylococcus aureus abscess. One patient required a craniotomy for the excision of a fungal abscess which was persistent after two CT-guided stereotactic aspirations. The survivors in this group are the patient with a tuberculous abscess who is alive and well 5 years after diagnosis, and another with a dematiaceous fungal abscess (phaeohyphomycosis). CT-guided stereotactic surgery is minimally invasive, and can safely be performed in these patients. It often leads to an aetiological diagnosis in renal transplant recipients with brain abscesses. Specific antibiotic management directed towards the causative organism rather than empirical treatment can be instituted following the procedure. Although the ultimate prognosis in these patients is bleak even with specific antibiotic therapy, an occasional patient might have a good outcome with prompt and appropriate therapy. PMID:10727562

Arunkumar, M J; Rajshekhar, V; Chandy, M J; Thomas, P P; Jacob, C K



Brain abscesses caused by Burkholderia pseudomallei.  


Burkholderia pseudomallei is an important human pathogen in tropical areas, particularly South East Asia and Northern Australia. A fatal case of meliodosis presenting as brain abscesses is described. The patient deteriorated despite treatment and died 21 days after admission. Burkholderia pseudomallei was only isolated after administration of corticosteroids, whilst on treatment with antibiotics to which the organism later showed in vitro sensitivity. Magnetic resonance imaging was more sensitive than computed tomography in diagnosing early brainstem infection in this patient. Physicians working outside the endemic areas must be attuned to the possibility of melioidosis in any patient with an appropriate history of travel to endemic areas. The combination of striking early, extensive, confluent T2 hyperintensity with disproportionately small enhancing lesions may be characteristic of meliodosis. PMID:9661950

Padiglione, A; Ferris, N; Fuller, A; Spelman, D



Multiple cerebral abscesses because of listeria monocytogenes: three case reports and a literature review of supratentorial listerial brain abscess(es)  

Microsoft Academic Search

BackgroundCentral nervous system involvement often follows bacteremia because of Listeria monocytogenes. Meningitis is clinically the most common manifestation, while brain abscess occurs in about 1% of patients. Brain abscess is usually solitary but in recent years, probably in part because of the availability of computerized tomography and magnetic resonance imaging, several reports have described two or more separate supratentorial abscesses.

Lawrence A Cone; Millie M Leung; Richard G Byrd; Gary M Annunziata; Richard Y Lam; Brian K Herman



Klebsiella pneumoniae Brain Abscess in Neonates: A Report of 2 Cases  

Microsoft Academic Search

Brain abscesses are uncommon in neonates. Klebsiella pneumoniae is a very uncommon microbial agent to cause brain abscess. We report 2 infants with Klebsiella pneumoniae sepsis who developed brain abscesses. One infant was a premature neonate who required mechanical ventilation for respiratory distress syndrome and subsequently developed nosocomial sepsis and brain abscess without evidence of preceding meningitis. Another infant was

Venkataseshan Sundaram; Sunil Agrawal; Swathi Chacham; Kanya Mukhopadhyay; Sourabh Dutta; Praveen Kumar



Brain Abscess after Transanal Hemorrhoidal Dearterialization: A Case Report  

PubMed Central

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

Berkel, A.E.M.; Witte, M.E.; Koop, R.; Hendrix, M.G.R.; Klaase, J.M.



Diagnosis of brain abscesses with indium-111-labeled leukocytes  

SciTech Connect

Sixteen patients with intracerebral mass lesions where computed tomography (CT) was not fully conclusive with respect to the differential diagnosis between brain tumor and abscess were examined with leukocyte brain scintigraphy (LBS). Autologous leukocytes were labeled with indium-111 oxinate and were reinjected intravenously; registration with a gamma camera was performed after 24 and 48 hours. In 10 of 11 patients with the final diagnosis of a brain tumor, no accumulation of radiolabeled leukocytes could be detected in the brain. In 4 of 5 patients with the final diagnosis of brain abscess, scintigraphy showed a pronounced increase of focal activity corresponding to the lesion demonstrated with CT. The reasons for the one false-positive and the one false-negative result are discussed, and it is concluded that LBS (a) can be used to detect intracranial infection and (b) may be a useful diagnostic tool for distinguishing between brain abscess and brain tumor.

Rehncrona, S.; Brismar, J.; Holtas, S.



Brain abscess from a peritonsillar abscess in an immunocompetent child: a case report and review of the literature.  


A brain abscess is uncommon but potentially lethal. Common predisposing risk factors include congenital cyanotic heart disease, immunocompromised status, and the presence of septic foci. We describe a left frontal brain abscess accompanied by fever, headache, and weight loss for a 3-month period. The presumptive source of the brain abscess involved a left peritonsillar abscess. To the best of our knowledge, one similar case was reported in the literature in 1929. The specific signs of peritonsillar abscess in our patient included trismus, decreased phonation, and a muffled voice. The peritonsillar abscess was not clinically diagnosed, but incidentally detected on lower axial sections of cranial magnetic resonance imaging. Fever and trismus improved after surgical drainage of the peritonsillar abscess. The cerebral abscess was conservatively treated with intravenous antibiotics. The patient developed hydrocephalus as a sequela to the involvement of the basal meninges. PMID:23127268

Sankararaman, Senthilkumar; Riel-Romero, Rosario Maria S; Gonzalez-Toledo, Eduardo



Brain abscess: a rare complication of halo usage.  


The halo traction device for cervical spine immobilization has few complications and is routinely used for spinal cord injured patients. The following case report describes a patient with lower cervical and upper thoracic fractures stabilized with a halo. She completed a two-month rehabilitation program without complications, but developed frontal headaches and vomiting within one or two days of discharge. A head CT revealed a right frontal isodense mass consistent with a brain abscess. The abscess was resected surgically, and she was placed on antibiotics. Mortality rates from brain abscesses are as high as 24%, making a prompt diagnosis critical. This case report describes an unusual etiology for a brain abscess, and it discusses the appropriate work-up in a neurologically impaired patient. PMID:1580780

Williams, F H; Nelms, D K; McGaharan, K M



Combined approach for otogenic brain abscess.  


Otogenic intracranial infections usually require both neurosurgical and otolaryngological surgery. This prospective, non-randomized study investigated the value of combining both surgical procedures. Thirteen patients with otogenic intracranial abscess were treated by mastoidectomy and abscess removal through the same incision between 1993 and 2002. Another 12 patients underwent abscess removal or mastoidectomy followed by the other procedure within 7 days. The clinical features of the patients were compared. Four patients died in our series. All four patients had Glasgow Coma Scale (GCS) scores of 7 or less. The preoperative GCS score was the main factor in mortality. One patient had recurrence after the combined approach compared to nine patients with recurrence after separate procedures. The surgical procedure was the main factor affecting the recurrence rate. The combined approach and total capsule excision of the abscess may reduce the risk of recurrence of otogenic intracranial abscess. PMID:15722605

Ozkaya, Serkan; Bezircioglu, Hamdi; Sucu, Hasan Kamil; Ozdemir, Ismail



Brain abscess as a complication of halo traction.  


The occurrence of a brain abscess as a complication of halo traction and immobilization in the management of scoliosis is reported. Previous reports suggest that this complication is rare. Unique in this case is the development of an intracerebral abscess without skull perforation by the halo device and without evidence of contiguous spread of infection. Attention of clinical signs (headache) and the use of computerized axial tomography may allow for early detection and appropriate care. PMID:7280825

Humbyrd, D E; Latimer, F R; Lonstein, J E; Samberg, L C


Staging of human brain abscess by computed tomography  

SciTech Connect

Precontrast and postcontrast computed tomograp(hic (CT) scans of patients with brain abscesses were quantitatively studied to determine if the degree of encapsulation could be predicted. The findings in these cases correlated closely to the CT criteria for encapsulation previously established in an experimental model. Time-density curves of serial delayed postcontrast CT scans and the precontrast CT appearance yielded accurate criteria for determining the degree of encapsulation. The effect of corticosteroid treatment on contrast enhancement of brain abscess was also studied in one patient.

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



Anaerobic brain abscess following chronic suppurative otitis media in a child from Uganda  

PubMed Central

Brain abscess, while rare, confers high mortality, especially in the developing world. The case of a Ugandan child with a polymicrobial brain abscess including infection with Tissierella praeacuta/Clostridium hastiforme requiring repeated drainage and eventual surgical excision is reported. The case demonstrates the importance of considering anaerobic organisms in the treatment of children with brain abscess from the developing world.

Cox, KA; Al-Rawahi, G; Kollmann, TR



CASE REPORT: Spontaneous Gas-Forming Liver Abscess Caused by Salmonella Within Hepatocellular Carcinoma: A Case Report and Review of the Literature  

Microsoft Academic Search

Gas formation is an infrequent presentation in pyogenic liver abscesses. According to previous studies (1, 2), it accounts for 20 –29% of all pyogenic liver abscesses, mostly in patients with diabetes. In addition, liver abscesses due to Salmonella organisms are very rare. There were only 14 cases described in the English literature after the report of Von Erberts, who collected

Cheng-Chi Lee; Sek-Kwong Poon; Gran-Hum Chen



Escherichia coli brain abscess in a twin pair associated with TLR4 gene mutation.  


Brain abscesses are uncommon complications of bacterial meningitis or sepsis in neonates and infants. The causative pathogens of brain abscess in newborns are various. Of those, Escherichia coli is rarely seen as a pathogen in brain abscess at this age. Herein we reported brain abscesses in twin infants caused by E.?coli sepsis. Interestingly, genetic analysis identified heterozygous Toll-like receptor 4 (TLR4) gene mutation in the twins. Because TLR plays an important role in the natural response to bacterial products and initiates specific immune response against these pathogens, this may explain the development of brain abscess in the present case. PMID:23910802

Erdemir, Aydin; Kahramaner, Zelal; Cosar, Hese; Turkoglu, Ebru; Sutcuoglu, Sumer; Uygun, Dilara Kocacik; Yegin, Olcay; Berdeli, Afig; Ozer, Esra Arun



Fulminant ependymitis following intraventricular rupture of brain abscess.  


A 48-year-old man with a history of a penetrating brain injury was referred with a presumptive diagnosis of bacterial meningitis. Examination revealed a brain abscess in addition to meningitis. Blood and cerebrospinal fluid (CSF) cultures were negative for bacteria, and empirical IV antibiotic therapy with vancomycin (VCM) and meropenem was initiated. Despite initial improvement, however, his condition rapidly deteriorated into coma following intraventricular rupture of the abscess and hydrocephalus. Thereafter, an emergency ventriculostomy was performed and the abscess was evacuated. Bacterial cultures of the pus were negative. To manage the hydrocephalus, 150-200 ml of CSF were drained daily. Intraventricular administration of VCM (20 mg q.d.) was added to the IV antibiotic therapeutic regimen after surgery. Although the primary abscess rapidly decreased in size, ependymitis developed in the fourth ventricle. This new lesion, which resulted from CSF dissemination from the primary abscess, was refractory to treatment, and eventually disappeared after the intraventricular VCM dosage was increased from 20 to 30 mg and continued for 30 days. A possible reason for the development of fulminant ependymitis and why it was refractory to treatment despite the shrinkage of the primary lesion may be that physiological CSF flow from the lateral to the fourth ventricle was lost due to CSF drainage, and the stagnant CSF flow coupled with an insufficient VCM level in the fourth ventricle facilitated the rapid growth of pathogens. Although intraventricular antibiotic administration is efficacious for treating ruptured brain abscesses, it may be associated with the unexpected development of secondary lesions. PMID:21203795

Inamasu, Joji; Kuramae, Takumi; Tomiyasu, Kazuhiro; Nakatsukasa, Masashi



Atypical Metronidazole-Induced Encephalopathy in Anaerobic Brain Abscess  

PubMed Central

Metronidazole-induced encephalopathy is a very rare complication of the long standing use of metronidazole. The encephalopathy is bilateral and symmetric in nature. We report on the magnetic resonance imaging (MRI) and clinical course of metronidazole-induced encephalopathy in a 60-year-old female with a persistent anaerobic brain abscess after draining of the abscess. After 3 months of metronidazole administration, the patient complained of dysarthria, tingling sense of all extremities, and left hemiparesis. MRI revealed symmetric hyperintensity lesions in medulla, pons, dentate nuclei of cerebellum, and splenium of corpus callosum, all of which represent typical findings of metronidazole-induced encephalopathy. In addition, asymmetric lesions in midbrain, thalamus, putamen and cerebral subcortical white matter were noted. The patient recovered after discontinuation of metronidazole and the remaining abscess was successfully treated with meropenem and levofloxacine.

Jang, Han Jin; Lee, Jong Yun; Bang, Ji Hwan



Atypical metronidazole-induced encephalopathy in anaerobic brain abscess.  


Metronidazole-induced encephalopathy is a very rare complication of the long standing use of metronidazole. The encephalopathy is bilateral and symmetric in nature. We report on the magnetic resonance imaging (MRI) and clinical course of metronidazole-induced encephalopathy in a 60-year-old female with a persistent anaerobic brain abscess after draining of the abscess. After 3 months of metronidazole administration, the patient complained of dysarthria, tingling sense of all extremities, and left hemiparesis. MRI revealed symmetric hyperintensity lesions in medulla, pons, dentate nuclei of cerebellum, and splenium of corpus callosum, all of which represent typical findings of metronidazole-induced encephalopathy. In addition, asymmetric lesions in midbrain, thalamus, putamen and cerebral subcortical white matter were noted. The patient recovered after discontinuation of metronidazole and the remaining abscess was successfully treated with meropenem and levofloxacine. PMID:23115678

Jang, Han Jin; Sim, Sook Young; Lee, Jong Yun; Bang, Ji Hwan



[Non-operation management of 12 cases with brain abscess demonstrated by CT scan].  


This paper reported 12 cases with brain abscess demonstrated by CT scan. Using antibiotic management without surgical intervention, in 10 cases the curative effects were satisfactory. The paper indicated that CT scan was very useful in prompt and correct diagnosis of brain abscess and with sequential CT scan medical therapy was feasible. It is significant in treatment of brain abscess especially for the patients who have a poor general condition, have the brain abscess located in important functional area or have multiple abscesses so that the operation is difficult for them. PMID:2098252

Long, J



Diagnosis and management of brain abscess and subdural empyema  

Microsoft Academic Search

Advances in the diagnosis and treatment of brain abscess and subdural empyema with neuroimaging techniques such as computerized\\u000a tomography, magnetic resonance imaging, magnetic resonance spectroscopy, the availability of new antimicrobials, and the development\\u000a of novel surgical techniques have significantly contributed to the decreased morbidity and mortality associated these infections.\\u000a Determination of point of entry and source of infection is paramount

Gary L. Bernardini



Bilateral brain abscesses complicating the use of crutchfield tongs  

Microsoft Academic Search

The case of a 4-year-old girl who developed bilateral brain abscesses complicating skull traction is reported. Crutchfield tongs were used to reduce a fracture dislocation at C2–3. Presenting symptoms consisted of headaches and focal seizures. Surgical treatment and antibiotics using serial CT led to a satisfactory outcome. This is the first reported case of this complication in a child. The

Juan F. Martinez-Lage; Miguel A. Perez-Espejo; José Masegosa; Máximo Poza



Bilateral brain abscesses complicating the use of Crutchfield tongs.  


The case of a 4-year-old girl who developed bilateral brain abscesses complicating skull traction is reported. Crutchfield tongs were used to reduce a fracture dislocation at C2-3. Presenting symptoms consisted of headaches and focal seizures. Surgical treatment and antibiotics using serial CT led to a satisfactory outcome. This is the first reported case of this complication in a child. The current literature is reviewed. PMID:3779684

Martinez-Lage, J F; Perez-Espejo, M A; Masegosa, J; Poza, M



Kocuria varians infection associated with brain abscess: A case report  

Microsoft Academic Search

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

Cheng-Yu Tsai; Shou-hsin Su; Yu-Hsin Cheng; Yu-lin Chou; Tai-Hsin Tsai; Ann-Shung Lieu



Retrospective analysis of 49 cases of brain abscess and review of the literature  

Microsoft Academic Search

The case records of 49 patients discharged from St George’s Hospital, London, between December 2000 and March 2004 with the\\u000a diagnosis of brain abscess were reviewed in order to document the epidemiology, causes, treatment, and prognostic factors\\u000a associated with brain abscess. Brain abscess occurred at all ages, more frequently in men than in women. Headache and altered\\u000a mental status were

J. Carpenter; S. Stapleton; R. Holliman



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

SciTech Connect

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.

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



Brain abscess in a neonate: an unusual presentation  

Microsoft Academic Search

Background  Neonatal brain abscesses are very rare and their clinical presentation is specific for this age group. They usually occur\\u000a as a complication of bacterial meningitis or septicemia. They are most often caused by gram-negative organisms, and mortality\\u000a and morbidity are still significant in this particular group of patients in spite of antibiotics and modern radiological tools.\\u000a \\u000a \\u000a \\u000a Methods  We report an unusual

Ricardo Santos de Oliveira; Vitor Ferreira Pinho; Joăo Flávio Gurjăo Madureira; Helio Rubens Machado



Citrobacter koseri Brain Abscess in the Neonatal Rat: Survival and Replication within Human and Rat Macrophages  

Microsoft Academic Search

Received 7 March 2003\\/Returned for modification 4 June 2003\\/Accepted 3 July 2003 A unique feature of Citrobacter koseri is the extremely high propensity to initiate brain abscesses during neonatal meningitis. Previous clinical reports and studies on infant rats have documented many Citrobacter- filled macrophages within the ventricles and brain abscesses. It has been hypothesized that intracellular survival and replication within

Stacy M. Townsend; Harvey A. Pollack; Ignacio Gonzalez-Gomez; Hiroyuki Shimada; Julie L. Badger



Brain Abscess Due to Listeria Monocytogenes: First Case Report in Thailand  

Microsoft Academic Search

Brain abscess with bacteremia caused by Listeria monocytogenes in a young woman with immune thrombocytopenic purpura was reported. The clinical features included fever, headache, and left-side weakness. Computed tomography and magnetic resonance imaging of the brain showed a large single abscess at the right frontoparietal area. L. monocytogenes was isolated from a blood culture. The patient promptly received a surgical

Somporn Srifeungfung


Discrimination of brain abscess from necrotic or cystic tumors by diffusion-weighted echo planar imaging  

Microsoft Academic Search

Diagnostic difficulties in discriminating brain abscess from necrotic or cystic tumors using conventional CT and MRI have been reported. In this article, we examine the diagnostic ability of diffusion-weighted imaging to discriminate brain abscess from necrotic or cystic tumors. In previous reports, necrotic or cystic tumors show low signal intensity in diffusion-weighted imaging, indicating a high apparent diffusion coefficient (ADC).

Toshihiko Ebisu; Chuzo Tanaka; Masahiro Umeda; Makoto Kitamura; Shoji Naruse; Toshihiro Higuchi; Satoshi Ueda; Hiroshi Sato



Diagnostic and management of pediatric brain stem abscess, a case-based update  

Microsoft Academic Search

Purpose  Authors report their experience of a pediatric brain stem abscess with a literature review.\\u000a \\u000a \\u000a \\u000a Methods  A 2.5-year-old girl first displayed bacterial otitis 3 months before admission. Diagnosis of brain stem abscess was delayed,\\u000a despite plethoric neurological signs. She complained of right hemiparesis, headache, squint, dysphagia, and false way inhalation\\u000a pneumopathy. Brain magnetic resonance imaging revealed presence of an abscess in the pons,

Houssine Ghannane; Mehdi Laghmari; Khalid Aniba; Mohammed Lmejjati; Saďd Ait Benali



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


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

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



Enterobacter sakazakii brain abscess in the neonate: the importance of neuroradiologic imaging  

Microsoft Academic Search

Background. Enterobacter sakazakii is a rare but important cause of life-threatening neonatal sepsis and meningitis complicated by the development of brain\\u000a abscess.¶Objective. Given the neurotropic qualities of this organism, early diagnosis and treatment are crucial as a poor prognosis follows\\u000a brain abscess formation.¶Materials and methods. Cross-sectional imaging (CT and MRI) play an important role in the diagnostic work-up.¶Conclusion. A biopsy-proven

Jonathan H. Burdette; Ceasar Santos



Brain abscesses in Northern Ireland: a 30 year community review  

Microsoft Academic Search

One hundred and seventy-two cases of intracranial abscesses, obtained from Neurosurgical and Centralised Autopsy Records for Northern Ireland for the 30 years, 1947--1976, have been reviewed. The incidence of the disease has fallen from five to three per million of population per year over the past three decades. Intracranial abscesses were three times as common in males as in females.

C J McClelland; B F Craig; H A Crockard



Brain Abscess as A Complication of Chronic Thromboembolic Pulmonary Hypertension - A Rare Case Report  

PubMed Central

A brain abscess is a life threatening condition which can occur as a complication of various clinical conditions. An intra–cerebral abscess which occurs as a complication of pulmonary arterial hypertension is extremely rare. The present report has described such an uncommon case of an intra–cerebral abscess in a chronic pulmonary thrombo embolism patient with pulmonary hypertension. A–34–year old male who was a known case of chronic pulmonary thrombo embolism with pulmonary artery hypertension, who was diagnosed 6 months back, presented to the Out Patients Department (OPD) with headache and vomiting. He had right homonymous hemianopia. Contrast MRI (Magnetic Resonance Imaging) of brain showed a peripherally enhancing lesion in the left temporo-occipital lobe, with oedema and a mass effect. Left parieto–occipital craniotomy and excision of the abscess was done. Staphylococcus aureus was isolated from the aspirated pus.

K, Lakshmi; R, Santhanam; S, Chitralekha



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


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

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


Staphylococcus massiliensis sp. nov., isolated from a human brain abscess.  


Gram-positive, catalase-positive, coagulase-negative, non-motile, non-fermentative and novobiocin-susceptible cocci were isolated from a human brain abscess sample (strain 5402776(T)). This novel strain was analysed by a polyphasic taxonomic approach. The respiratory quinones detected were MK-7 (93 %) and MK-6 (7 %) and the major fatty acids were C(15 : 0) iso (60.5 %), C(17 : 0) iso (8.96 %) C(15 : 0) anteiso (7.93 %) and C(19 : 0) iso (6.78 %). The peptidoglycan type was A3alpha l-Lys-Gly(2-3)-l-Ser-Gly. Based on cellular morphology and biochemical criteria, the new isolate was assigned to the genus Staphylococcus, although it did not correspond to any recognized species. The G+C content of the DNA was 36.6 mol%. Phylogenetic analysis based on 16S rRNA gene sequence comparisons showed that the new isolate was most closely related to Staphylococcus piscifermentans, Staphylococcus condimenti, Staphylococcus carnosus subsp. carnosus, S. carnosus subsp. utilis and Staphylococcus simulans (97.7 %, 97.6 %, 97.6 %, 97.6 % and 96.5 % sequence similarity, respectively). Comparison of tuf, hsp60, rpoB, dnaJ and sodA gene sequences was also performed. In phylogenetic analysis inferred from tuf, dnaJ and rpoB gene sequence comparisons, strain 5402776(T) clustered with Staphylococcus pettenkoferi (93.7 %, 82.5 % and 89 % sequence similarity, respectively) and on phylogenetic analysis inferred from sodA gene sequence comparisons, it clustered with Staphylococcus chromogenes (82.8 %). On the basis of phenotypic and genotypic data, this isolate represents a novel species for which the name Staphylococcus massiliensis sp. nov. is proposed (type strain 5402776(T)=CCUG 55927(T)=CSUR P23(T)). PMID:19666814

Al Masalma, Mouhamad; Raoult, Didier; Roux, Véronique



Listeria monocytogenes brain abscess: two cases and review of the literature.  


Listeria monocytogenes is a gram-positive bacillus that exhibits predilection to infect the central nervous system in immunocompromised individuals; the most common manifestations are meningitis and rhombencephalitis. Listerial brain abscesses are rare. We report here two brain abscess cases caused by L. monocytogenes in patients receiving immunosuppressive agents. The first patient presented with left hemiparesis mimicking stroke and the second patient presented with neurological symptoms without fever, which was indistinguishable from brain tumor. In both cases, magnetic resonance spectroscopy (MRS) was performed to differentiate infectious processes from other causes. Diagnosis was made with a positive blood culture in both cases. Listerial DNA was detected in the pus aspirated from the abscess in the first case. Both patients were successfully treated with intravenous ampicillin followed by oral amoxicillin. MRS was useful in differentiating infectious processes from non-infectious causes. PMID:24050079

Limmahakhun, Samornrod; Chayakulkeeree, Methee



Brain Abscess Caused by Enterococcus faecalis following a Dental Procedure in a Patient with Hereditary Hemorrhagic Telangiectasia  

PubMed Central

Hereditary hemorrhagic telangiectasia (HHT) is a disease characterized by arteriovenous malformations (AVMs). Brain abscess is a complication of HHT with AVMs. Literature provides evidence that Enterococcus faecalis can cause endodontic infections. We present the case of an HHT patient who developed brain abscess due to E. faecalis after a dental procedure.

Vadala, Chariklia; Papastamopoulos, Vasilios; Skoutelis, Athanasios



Ultrasound-guided aspiration of brain abscesses through a single burr hole.  


Surgical aspiration and/or drainage of brain abscesses is considered to be the first-line treatment for abscesses larger than 25 mm. This is ususally performed with the aid of CT-guided stereotaxy. A method of ultrasound guidance is presented that allows a single burr hole approach with real-time imaging of the whole procedure. A bayonet-like shaped ultrasound probe with tip dimension of 8 x 8 mm only (EUP-NS 32, Hitachi/Ecoscan) with frequencies of 3.5 and 5 MHz is used. After placement of a burr hole the target is identified by transdural insonation, a guideline is adjusted and a mounted puncture-adapter guides the cannula towards the lesion under real-time imaging control. Up to now 12 abscesses in 10 patients were treated. Visualization was always excellent. A second aspiration had to be performed twice. One abscess did not contain enough pus to be cured by aspiration and was removed by open surgery, another could not be tapped by the blunt cannula and was aspirated under stereotactic control using a sharp trocar. Outcome was excellent in 6 patients and fair in 2 patients but this was due to the pre-existing disease. Two patients admitted in deep coma died despite an emergency operation. The presented method has proven to be a very powerful guiding tool in the surgical treatment of brain abscesses through a single burr hole approach. PMID:11696881

Strowitzki, M; Schwerdtfeger, K; Steudel, W I



Balamuthia mandrillaris brain abscess successfully treated with complete surgical excision and prolonged combination antimicrobial therapy.  


Amoebic encephalitis is an uncommon and usually fatal condition. This case describes successful treatment of a Balamuthia mandrillaris brain abscess using prolonged antimicrobial agents with complete excision. It illustrates the risk of dissemination from cutaneous to cerebral amoebic lesions, potential progression with corticosteroid therapy, and the prospect for curative excision. PMID:21073255

Doyle, Joseph S; Campbell, Emer; Fuller, Andrew; Spelman, Denis W; Cameron, Rhoda; Malham, Gregory; Gin, Douglas; Lewin, Sharon R



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

PubMed Central

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.

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



Brevibacterium casei as a Cause of Brain Abscess in an Immunocompetent Patient ?  

PubMed Central

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.

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



Management of brain abscess in children: review of 130 cases over a period of 21 years  

Microsoft Academic Search

The data on 130 children with brain abscesses treated over 21 years (1970–1990) were analyzed retrospectively. The whole group included four infants. Chronic ear infection and cyanotic congenital heart disease were the most common predisposing factors. In infants, meningitis and\\/or ventriculitis were dominant in the etiopathogenesis. Cases were evaluated according to the treatment received and also according to time periods.

?smail H. Tekkök; Aykut Erbengi



Multi-antibiotic resistant brain abscess sensitive only to chloramphenicol: a case report  

Microsoft Academic Search

INTRODUCTION: A brain abscess is a focal, intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. CASE PRESENTATION: An 18 year old male was diagnosed to have culture-negative bilateral subdural empyema, which was drained and the patient was discharged, only to return 3 months later with a

Atiq ur Rehman; Tausif Rehman; Rushna Ali



Isolation of Haemophilus parahaemolyticus in a patient with cryptogenic brain abscess.  


Haemophilus parahaemolyticus rarely causes disease in humans. We present the case of a 68-y-old man who suffered from a brain abscess over the right-side thalamus and midbrain. Stereotactic aspirates grew H. parahaemolyticus. No portal of entry for the microorganism was identified in this case. The patient made a good recovery after treatment. PMID:11440228

Chen, C C; Wang, S J; Fuh, J L



Role of diffusion-weighted echo-planar MRI in distinguishing between brain abscess and tumour: a preliminary report  

Microsoft Academic Search

Our purpose was to evaluate diffusion-weighted (DW) echo-planar MRI in differentiating between brain abscess and tumour.\\u000a We examined two patients with surgically confirmed pyogenic brain abscess and 18 with metastatic brain tumours or high-grade\\u000a glioma, using a 1.5 T system. The apparent diffusion coefficient (ADC) of each necrotic or solid contrast-enhancing lesion\\u000a was measured with two different b values (20

K. Noguchi; N. Watanabe; T. Nagayoshi; T. Kanazawa; S. Toyoshima; M. Shimizu; H. Seto



Multiple brain abscesses: An initial presentation in a child with an undiagnosed sinus venosus atrial septal defect  

Microsoft Academic Search

Cerebral abscess is a serious condition and in children the commonest cause is cyanotic congenital heart disease. We report a 12-year old male who presented with multiple brain abscesses. After an extensive evaluation including a transesphageal echocardiogram (TEE), we found a previously undiagnosed sinus venous atrial septal defect (ASD). He was treated medically with antibiotics. This is an unusual initial

Rukhsana Abdullah; Mary Baldauf; Shabana Azam; Mohamud Hassanein; Sarita Dhuper



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

PubMed Central

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



Toll-Like Receptor 2 Modulates the Proinflammatory Milieu in Staphylococcus aureus-Induced Brain Abscess  

Microsoft Academic Search

Toll-like receptor 2 (TLR2) is a pattern recognition receptor (PRR) that plays an important role in innate immune recognition of conserved structural motifs on a wide array of pathogens, including Staphylococcus aureus. To ascertain the functional significance of TLR2 in the context of central nervous system (CNS) parenchymal infection, we evaluated the pathogenesis of S. aureus-induced experimental brain abscess in

Tammy Kielian; Anessa Haney; Patrick M. Mayes; Sarita Garg; Nilufer Esen



Central condylar displacement with brain abscess from chronic mandibular osteomyelitis.  


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

Lee, Thomas; Green, Ross; Hsu, Jack



Extensive pneumocephalus extending into the lateral ventricles from a brain abscess: an intracranial complication of cholesteatoma.  


Objective: We report the case of a patient with extensive pneumocephalus extending into the lateral ventricles from a brain abscess arising from a cholesteatoma-induced defect in the skull base. Case report: A 70-year-old man with cholesteatoma presented with right-sided otalgia, otorrhoea and progressive headaches. Computed tomography showed a tegmental defect (approximately 2 × 2 cm) at the right mastoid antrum. A T1-weighted, gadolinium-enhanced magnetic resonance imaging scan showed pneumocephalus in both lateral ventricles, which was directly connected to the mastoid cavity via a brain abscess and a bone defect in the skull base. Radical mastoidectomy was performed to remove the cholesteatoma. The roof of the mastoid cavity was covered extensively with fascia and a pedicled temporalis muscle flap. One week post-operatively, computed tomography and magnetic resonance imaging showed no pneumocephalus. Conclusion: Pneumocephalus arising from a cholesteatoma-induced brain abscess and extending into the lateral ventricles is an important entity, with an atypical appearance on computed tomography and magnetic resonance imaging. PMID:23217411

Tamura, Y; Suzuki, M; Yamamoto, M; Yoshida, T



Brain abscess related to metal fragments 47 years after head injury. Case report.  


The authors report a case of symptomatic brain abscess in a 51-year-old man who presented with personality changes and generalized seizures. He had survived a grenade explosion injury during the Korean War 47 years previously. Computerized tomography scanning revealed multiple conglomerate rim-enhancing lesions and metallic foreign bodies in the right frontal lobe. The mass was totally removed and Pseudomonas aeruginosa was isolated from microbial cultures. Retained foreign bodies in the brain, whether bone or metal, should be removed at the time of injury if at all possible. If this cannot be accomplished, patients with such retained foreign bodies should be carefully monitored for life. PMID:10969947

Lee, J H; Kim, D G



Rapid Development of Brain Abscess Caused by Streptococcus Pyogenes Following Penetrating Skull Injury via the Ethmoidal Sinus and Lamina Cribrosa  

PubMed Central

Objective Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as 40?. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism.

Aydin, Gerilmez; Comert, Serhat; Altinors, Nur



Spontaneous abdominal arteriovenous fistula and polysplenia in a child presenting with brain abscess.  


Spontaneous arteriovenous communications below the diaphragm is a very rare condition. Its association with polysplenia has perhaps not yet been reported in children. We reported a case in a 9-year-old boy presenting with acute onset of fever, vomiting, headache, seizures and altered sensorium. A CT scan revealed a large occipital abscess which was drained surgically. On examination he had marked central cyanosis and grade III clubbing of fingers and toes. Further investigations led to the discovery of a very rare finding of abdominal arteriovenous malformation associated with multiple-enhancing structures around the splenic bed suggestive of polysplenia. We believe that the most likely cause of the brain abscess was paradoxical embolism through the abdominal arteriovenous communication. Unfortunately the parents did not consent to a surgical correction of the malformation, realising the risks involved in the procedure. Subsequently the boy was lost in follow-up. PMID:23997082

Acharyya, Saugata; Acharyya, Kakoli



Aggressive G-CSF-producing gastric cancer complicated by lung and brain abscesses, mimicking metastases.  


A 57-year-old Japanese man had type II c gastric cancer with marked lymph node metastases associated with leukocytosis and elevated granulocyte colony-stimulating factor (G-CSF). Total gastrectomy and distal pancreatectomy with lymph node dissection were performed. Although the primary lesion was negative for G-CSF by histopathological immunostaining, a highly increased G-CSF m-RNA level, measured using reverse transcriptase-polymerase chain reaction in frozen sections, led to a diagnosis of G-CSF-producing gastric cancer. The leukocytes and G-CSF decreased immediately after surgery. He then had an intraabdominal recurrence, and was diagnosed with multiple tumors in his lung and brain, with abnormally elevated leukocytes and greatly increased G-CSF; he died 4 months after the surgery. Autopsy showed intraabdominal recurrence of cancer, with no metastases to the lung or brain, but with multiple brain and lung abscesses. We speculate that the excessively increased neutrophils induced by G-CSF infiltrated the lung and brain and formed abscesses, mimicking metastases. PMID:16086124

Yokoyama, Taku; Hyodo, Masanobu; Hosoya, Yoshinori; Koinuma, Koji; Kurashina, Kentarou; Saitoh, Shin; Hirashima, Yuuki; Arai, Wataru; Zuiki, Toru; Yasuda, Yoshikazu; Nagai, Hideo; Kanai, Nobuyuki; Saitoh, Ken



An unexpected intracranial pressure crisis: infant brain abscess of unusual aetiology  

Microsoft Academic Search

Background  Brain abscess in infants is extremely rare in the developed world. Often, these children have a predisposing history and are\\u000a infected with certain bacterial aetiology.\\u000a \\u000a \\u000a \\u000a Case history  A 3-month-old boy presented to the hospital emergently with an increased intracranial pressure crisis. All predisposing factors\\u000a such as maternal history, family history or the infant’s medical history were entirely free of suggestive aetiological

J. D. Pasternak; M. Fulford; T. Gunnarsson; J. Provias; S. K. Singh



Successful treatment of brain abscess caused by Nocardia in an immunocompromised patient after failure of co-trimoxazole.  


Disseminated infection caused by Nocardia asteroides is a fairly rare entity occurring mostly in immunocompromised states. Metastatic brain abscesses are a frequent and ominous complication. We report on a patient whose underlying disease was stage II pulmonary sarcoidosis. He acquired disseminated N. asteroides infection while on immunosuppressive therapy with prednisolone. After the generally recommended therapy with co-trimoxazole (trimethoprim/sulfamethoxazole) proved ineffective in controlling his brain abscesses, the lesions of the central nervous system completely resolved under a combination of oral rifampicin with i.v. imipenem, followed by oral rifampicin and ampicillin/clavulanic acid. PMID:1293059

Overkamp, D; Waldmann, B; Lins, T; Lingenfelser, T; Petersen, D; Eggstein, M


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


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

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



Chronic brain abscess secondary to a retained wooden foreign body: diagnostic and management dilemmas.  


A four-year-old child presented with recent onset generalized tonic clonic seizures. She was operated for a suspected intracranial tuberculoma and was found to harbor an intra-parenchymal retained wooden foreign body with a chronic abscess. The foreign body had entered the brain parenchyma after a minor head injury, sustained three years earlier. She was asymptomatic for the intervening three years. The initial diagnosis was missed by several physicians. A retained wooden fragment via a transtemporal apparently closed head injury is an extremely rare event. The present study reveals the diagnostic and therapeutic challenges and stresses the importance of high degree of suspicion to diagnose retained intracranial foreign bodies and the need for early surgical exploration, to avoid chronic and potentially life threatening neurological complications. PMID:20454935

Dadlani, Ravi; Ghosal, Nandita; Bagdi, Naman; Venkatesh, Prasanna K; Hegde, Alangar Sathya



Lemierre syndrome complicating multiple brain abscesses caused by extended-spectrum ?-lactamase-producing Klebsiella pneumoniae cured by fosfomycin and meropenem combination therapy.  


A woman aged 56 years of age had a community-acquired left neck abscess and internal jugular vein thrombosis with septicemia due to extended-spectrum ?-lactamase (ESBL)-producing Klebsiella pneumoniae. Even though she was treated with intravenous meropenem, the bacteremia persisted. She was complicated with multiple brain abscesses, seizure, and leucopenia. After a combination of intravenous fosfomycin and meropenem, her clinical condition became stable. Combination treatment was continued for 2 months and she recovered. In individual cases of Lemierre syndrome with brain abscess caused by ESBL-producing Enterobacteriaceae, fosfomycin combination therapy may be the alternative choice. PMID:22154996

Lee, Wen-Sen; Wang, Fu-Der; Shieh, Ying-Hua; Teng, Sing-On; Ou, Tsong-Yih



The effect of short-term corticosteroid treatment on the CT appearance of experimental brain abscesses. [Dogs  

SciTech Connect

The effect of short-term corticosteroid treatment on contrast enhancement was investigated in an experimental brain abscess model. The degree of enhancement was reduced in the cerebritis stage, unaffected in the capsule stage, and intermediate in the transitional stage. The area and pattern of enhancement were also altered in the cerebritis stage. Although the magnitude of the entire cerebritis time-density curve (extended for 60 minutes) was decreased by the steroids, its configuration was unchanged. Prior to steroid administration, the 10- and 60-minute components of the curve discriminated between cerebritis and capsule stages, with the latter exhibiting a far lower 60-minute value. Implications for treatment of brain abscesses are discussed.

Enzmann, D.R.; Britt, R.H.; Placone, R.C. Jr.; Obana, W.; Lyons, B.; Yeager, A.S.



Successful treatment of brain abscess caused by Nocardia in an immunocompromised patient after failure of co-trimoxazole  

Microsoft Academic Search

Summary Disseminated infection caused byNocardia asteroides is a fairly rare entity occurring mostly in immunocompromised states. Metastatic brain abscesses are a frequent and ominous complication. We report on a patient whose underlying disease was stage II pulmonary sarcoidosis. He acquired disseminatedN. asteroides infection while on immunosuppressive therapy with prednisolone. After the generally recommended therapy with co-trimoxazole (trimethoprim\\/sulfamethoxazole) proved ineffective in

D. Overkamp; B. Waldmann; T. Lins; Th. Lingenfelser; M. Eggstein; D. Petersen



Successful outcome of aspergillus brain abscess in a patient who underwent bone marrow transplantation for aplastic anemia.  


We report the course of an aspergillus brain abscess in an 18-year-old female patient who underwent bone marrow transplantation for aplastic anemia. The abscess was discovered on day 35 post-transplant, in a cranial computerized tomography (CT) scan performed for the evaluation of an unexplained headache. Meanwhile, she was receiving broad-spectrum antibacterials and liposomal amphotericin B for a right upper pulmonary lobe infiltrate. A percutaneous puncture of the cerebral lesion was performed; fungal elements were seen in the pus obtained and its culture yielded A. fumigatus. The dose of amphotericin B was increased, intraconazole was added and two more punctures were done. With these antifungals, the abscess regressed significantly; so, amphotericin B was discontinued after a cumulative dose of 6775 mg but intraconazole was maintained at 400 mg/day. At the last follow-up, seventeen months after detection of the abscess, the patient was well, without symptoms and the cerebral lesion diminished to a very small, thick-walled CT image. PMID:9408772

Ba?lar, Z; Soysal, T; Hanci, M; Aygün, G; Ferhano?lu, B; Sario?lu, A C; Ulkü, B



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


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

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



Brain abscess and generalized seizure caused by halo pin intracranial penetration: case report and review of the literature.  


The objective of our study is to report a rare complication of halo pin insertion associated with an epileptic seizure and brain abscess, and to discuss the diagnostic and therapeutic approach to its management. The treatment of unstable cervical spine injuries with a halo vest is an established procedure. Complications of pin penetration such as brain abscess and seizure are rare, and need to be urgently treated. Intracranial abscess and seizure associated with the use of the halo device is an unusual complication, and only a few cases have been reported in the literature. A 21-year-old male had a halo vest placed for the management of an odontoid type II fracture, which he sustained from a motor vehicle accident. Ten weeks after halo ring placement he complained of headaches which relieved by analgesics. After 2 weeks he was admitted at the emergency unit in an unconscious condition after a generalized tonic-clonic seizure. The halo pins were displaced during the seizure and were removed at his admission. No drainage was noted from the pin sites, and a Philadelphia cervical collar was applied. A brain CT and MRI revealed intracranial penetration of both posterior pins and a brain abscess in the right parietal lobe. Computed tomography of the cervical spine revealed stable fusion of the odontoid fracture. Cultures from the pin sites were negative; however, intravenous wide spectrum antibiotic treatment was administered to the patient immediately for 4 weeks followed by oral antibiotics for additional 2 weeks. Anti-epileptic medication was also started at his admission. The patient was discharged from the hospital in 6 weeks without symptoms, continuing anti-epileptic medication. On the follow-up visits he had fully recovered without any neurologic sequelae. In conclusion, complications of halo pin penetration are rare which need immediate intervention. Any neurologic or infectious, local or generalized, symptom need to be investigated urgently with available imaging techniques and treated promptly. Pin over-tightening may cause bone penetration and possible deep cranial infection with serious complications. PMID:18751739

Gelalis, Ioannis D; Christoforou, Georgios; Motsis, Efstathios; Arnaoutoglou, Christina; Xenakis, Theodore



Brain abscess induced by Propionibacterium acnes in a patient with severe chronic sinusitis.  


Propionibacterium acnes has long been considered a contaminant organism. However, recently the isolation of this emerging pathogen has become a more difficult clinical challenge. Infections of the central nervous system caused by P. acnes have been strongly associated with neurosurgical procedures. We describe a patient with Propionibacterium acnes cerebral abscess developed as consequence of a severe chronic sinus disease. PMID:23912875

Zaffiri, Lorenzo; Abdulmassih, Rasha; Boyaji, Shafik; Bagh, Imad; Campbell, Amanda R; Loehrke, Mark E



[Nocardia farcinica as the causative agent of a brain abscess in a patient with interstitial lung disease].  


This case report describes a two-step protocol for the identification of the causative agent of nocardiosis in a patient with brain abscess, antibiotic susceptibility testing and etiological treatment after neurosurgery. The patient treated with corticosteroids for pulmonary fibrosis and presenting with multiple neurological manifestations was admitted to a neurosurgery clinic. CT and contrast MRI revealed an expansive multilocular lesion 45 x 35 mm in size in the left parietal lobe, differentially diagnosed as malignant glioma. The lesion was biopsied and the histology showed a brain abscess containing white blood cells and dead tissue. The aspirated pus culture yielded bacteria of the genus Nocardia that were further identified, in the first step, by phenotypic methods (Gram positivity, partial acidoresistance, airborne mycelium detection, growth at 45 degrees C, lysozyme resistance and antibiotic resistance phenotype) as belonging to resistance phenotype V., v.s. N. farcinica (resistance to aminoglycosides except amikacin and to third-generation cephalosporins). In the second step of the polyphasic identification, rDNA was isolated and a 1000 bp part of the 16S rRNA gene was sequenced. Sequence comparison with the GenBank database using BLAST software identified the agent as N. farcinica (100%). The isolate was tested for susceptibility by the NCCLS /CLSI dilution method and showed good susceptibility to co-trimoxazole, amikacin and imipenem. The patient was treated with long-term intravenous cotrimoxazole acid in combination with amikacin and his clinical condition and laboratory parameters of inflammation improved. N. farcinica is among the three most frequently isolated Nocardia species in Europe as well as in the Czech Republic where it was repeatedly recovered from the lungs and respiratory tract of immunocompromised patients with systemic nocardiosis. PMID:21110444

Scharfen, J; Morávková, M; Buncek, M; Hobza, V; Plísek, S; Urbásková, P; Sedlácek, I; Zemlicková, H; Stárková, H; Paterová, P



Multiple fungal brain abscesses in a child with acute lymphoblastic leukemia.  


Fungal infection is a severe problem in children suffering from cancer. We report a case of a four-year-old girl who was diagnosed with acute lymphoblastic leukemia and multiple Aspergillus niger abscesses at the induction phase of the treatment. She was treated with granulocyte transfusions, liposomal amphotericin B with a combination of voriconazole for four months, followed by oral variconazole alone for 17 months. She was successfully treated with this combination without any sequel, and the planned chemotherapy was also completed. Our experience revealed that antifungal treatment including intravenous amphotericin B and variconazole augmented by granulocyte transfusion is an alternative option for the management of this catastrophic complication. PMID:22777270

Patiroglu, Turkan; Unal, Ekrem; Karakukcu, Musa; Ozdemir, Mehmet Akif; Tucer, Bülent; Yikilmaz, Ali; Deniz, Kemal



Subareolar abscess  


Abscess - areolar gland; Areolar gland abscess ... is caused by a blockage of the small glands or ducts below the skin of the areola that result in infection of the glands. This is an uncommon problem that affects younger ...


Abdominal Abscesses  


... Pain: What Is Referred Pain? ). Abscesses in the mid-abdomen may result from a ruptured appendix, a ... the same disorders that cause abscesses in the mid-abdomen or from gynecologic infections. Symptoms may include ...


Delayed development of brain abscesses following stent-graft placement in a head and neck cancer patient presenting with carotid blowout syndrome.  


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. PMID:20033689

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



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

SciTech Connect

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.

Oweis, Yaseen [University of Michigan Medical School (United States); Gemmete, Joseph J., E-mail:; Chaudhary, Neeraj [University of Michigan, Division of Interventional Neuroradiology, Department of Radiology (United States); Pandey, Aditya [University of Michigan, Department of Neurosurgery (United States); Ansari, Sameer [University of Chicago, Division of Interventional Neuroradiology, Department of Radiology (United States)



Skin abscess  


... abscesses may occur after: A bacterial infection (often staphylococcus) A minor wound or injury Boils Folliculitis A ... Elsevier Churchill Livingstone; 2009:chap 90. Daum RS. Staphylococcus aureus . In: Long SS, ed. Principles and Practice of ...


Peritonsillar Abscess  


... out. Surgery to remove your tonsils (called a tonsillectomy) is also an option. You will probably only ... I contagious? Will I have to have a tonsillectomy after the abscess is drained? What antibiotic will ...


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

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.

Erol, Ilknur [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Neurology Unit (Turkey)], E-mail:; Cetin, I. Ilker [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey); Alehan, Fuesun [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Neurology Unit (Turkey); Varan, Birguel [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey); Ozkan, Sueleyman [Baskent University Faculty of Medicine, Department of Cardiovascular Surgery (Turkey); Agildere, A. Muhtesem [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Tokel, Kursad [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey)



Extended extra- and intracerebral ulceration and brain abscess following self-mutilation in an auto-aggressive 51-year-old woman: case report.  


In neurosurgical practice, the operative treatment of deep or infected wounds caused by auto-mutilation is quite rare, especially in the neurocranium. We present an extraordinary case of an auto-aggressive 51-year-old female suffering from a deeply ulcerated wound on the right frontal skull with consecutive brain abscess, caused manually with needles and forceps over a period of 8 months. The clinical course is present ed together with a description of the conservative and surgical regimen and is illustrated with photographs and CT and MRI images. PMID:20201127

Schebesch, K M; Herbst, A; Schoedel, P; Rockmann, F; Brawanski, A



A rare but fatal case of granulomatous amebic encephalitis with brain abscess: the first case reported from Turkey.  


The incidence of protozoal and helminthic infestations of the central nervous system (CNS) is less than 1%, but these infestations tend to follow a fatal course. They are more common among children, the elderly and immunocompromised individuals. CNS infections due to Entamoeba histolytica have been known for a long time. In recent years, especially in developing countries, there has been an increase in CNS infections due to free-living amebas (FLAs). Acute CNS infection due to Naegleria fowleri, which ends in death within 2-7 days, is termed primary amebic meningoencephalitis (PAM); subacute or chronic CNS infections due to Acanthamoeba spp, Balamuthia mandrillaris, and Sappinia diploidea, which occasionally cause cerebral abscess, are termed granulomatous amebic encephalitis (GAE). This paper presents a case of GAE with abscess formation in a 75-year-old male patient. PMID:19621290

Sarica, Feyzi Birol; Tufan, Kadir; Cekinmez, Melih; Erdo?an, Bülent; Altinörs, Mehmet Nur



Brain Abscess Caused by Streptomyces Infection following Penetration Trauma: Case Report and Results of Susceptibility Analysis of 92 Isolates of Streptomyces Species Submitted to the CDC from 2000 to 2004  

Microsoft Academic Search

The case of a patient who presented with a brain abscess caused by Streptomyces infection following penetrating cerebral trauma with a soil-contaminated object generated an interest in optimizing antimicrobial therapy. Collaboration with the Centers for Disease Control and Prevention led to the analysis of susceptibility data for Streptomyces isolates that suggested that amikacin (100% susceptibility for 92 isolates tested) and

Charles E. Rose III; June M. Brown; John F. Fisher



Anorectal abscess.  


A five year retrospective review of anorectal abscesses included 181 admissions in which all but five were explained by the anal glandular hypothesis of causation. Delays in treatment occurred because of misdiagnosis, attempts at nonoperative management and inhospital procrastination. These abscesses are notorious for the recurrence rate after treatment. One-third of the patients in our series had a history of previous abscess and a postoperative recurrence rate of at least 6 per cent. Associated medical problems, such as diabetes mellitus, inflammatory intestinal disease or carcinoma, should be suspected in these patients. The fact that the majority of the patients in our series were afebrile and had minimal leukocytosis is a possible indication that our index of suspicion should be high in any patient with anorectal pain and that we must rely primarily on local findings. Treatment should be prompt incision and drainage under spinal or general anesthesia. Wide unroofing procedures and overzealous attempts at primary fistulotomy are discouraged as is the use of local anesthesia. Associated procedures, such as hemorrhoidectomy, can be safely performed and may prevent certain postoperative complications. PMID:505265

Kovalcik, P J; Peniston, R L; Cross, G H



Pyogenic liver abscess  


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


Amebic liver abscess  


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


Intracranial abscesses secondary to ear and paranasal sinuses infections.  


The death rate of brain abscesses in a recently reported series is high, ranging from 36% to 50% of all cases. This paper reports experiences with ten cases of intracranial abscesses secondary to ear and sinus infections. Six of these abscesses are secondary to otitic infections with three of them located in the cerebellum. Two of the cerebellar abscesses are surgically drained through the temporal bone by the otologic surgeon, with close neurosurgical cooperation. Computerized axial tomography has revolutionized the treatment of intracranial abscesses optimizing the timing for medical and surgical management. PMID:7208035

Maniglia, A J; VanBuren, J M; Bruce, W B; Bellucci, R J; Hoffman, S R


Gas-forming urinary tract infection.  


Emphysematous or gas-forming infections, a very small percentage of bacterial infections of the urinary tract, attract importance because of their life threatening potential. Herein, we report a 60-year-old Saudi female patient who was a known case of Diabetes mellitus for 15 years. She was admitted with left flank pain of 5 days duration, abdominal distension, nausea, vomiting and chills associated with increased frequency of urine, urgency, and dysuria. She had leukocytosis, high blood sugar, elevated urea and creatinine and pyuria. Urine culture grew Escherichia coli. Ultrasound and CT scan showed left pelvicalyceal dilatation and air in the left kidney and urinary bladder. She was treated with a prolonged parenteral antibiotic course, and insulin, with complete recovery. PMID:18940128

Nabi, Zahid; Almukdad, Hashem; Alnassri, Abdulla; Adli, Kamil; Adie, Eyad



Renal and perirenal abscesses  

SciTech Connect

Our knowledge of the spectrum of renal abscesses has increased as a result of more sensitive radiologic techniques. The classification of intrarenal abscess now includes acute focal bacterial nephritis and acute multifocal bacterial nephritis, as well as the previously recognized renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. In general, the clinical presentation of these entities does not differentiate them; various radiographic studies can distinguish them, however. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy are required for resolution. 73 references.

Patterson, J.E.; Andriole, V.T.



Psoas abscess in obstetrics.  


Psoas abscess is rarely encountered in obstetric practice. This condition may be primary or secondary resulting from extension of an infectious process near the psoas muscle. We report a series of three patients with psoas abscess that were encountered in our obstetric practice. Two of these patients had a primary and one a secondary abscess. Two patients underwent laparotomy and drainage of abscess while one received medical treatment. All patients recovered uneventfully. PMID:18607613

Kumar, Sunesh; Malhotra, Neena; Chanana, Charu; Lal, Suman



Candida albicans skin abscess.  


Subcutaneous candidal abscess is a very rare infection even in immunocompromised patients. Some cases are reported when breakdown in the skin occurs, as bacterial cellulites or abscess, iatrogenic procedures, trauma and parenteral substance abuse. We describe a case of Candida albicans subcutaneous abscess without fungemia, which can be associated with central venous catheter. PMID:17086322

Tuon, Felipe Francisco; Nicodemo, Antonio Carlos


Imaging of abdominal abscesses.  


The aim of the study is presenting own experiences in using different diagnostic modalities in evaluating abdominal abscesses. Material comprises a group of nine patients with diagnosed abdominal abscess aged between 22 and 78 years. The plain abdominal radiograms, ultrasound examinations and computed tomography were performed in those patients. The CT examination was performed in 10-mm thick axial sections, before and after administering contrast agent. The perirenal abscesses were found in two patients. In US have showed various, inhomogeneous echogenicity, depending on the stage of the abscess. The contrast CT reveals enhancing septa, thick walls and oval, central area of lower density. The plane radiograms revealed abscesses in three cases. In two of them abscesses were complications of previouscholecystectomy. The large abscesses dislocated intestinal loops. CT was necessary to assess the extent, depth and shape of retroperitoneal fluid collections. Abdominal abscess is life threatening condition requiring quick diagnosis and proper management. The imaging methods are especially important in diagnosis of abscesses. Abscesses may by recognized on plain abdominal radiograms, but US and especially CT are much more sensitive and accurate. CT is imaging modality of choice in revealing abdominal abscess. CT and US are very useful in nonoperative therapies, including US and CT guided drainage. PMID:16146093

Pas?awski, Marek; Szafranek-Pyzel, Joanna; Z?omaniec, Janusz



Intracranial epidural abscess of odontogenic origin.  


Dental infection as a cause of epidural abscess is rare compared with other forms of intracranial suppurations. A 10-year-old boy was seen because of headaches and fever. There was no history of otitis media or sinusitis, but he had sought care for dental complaints. The patient was from an upper-middle-class family, was not immunocompromised, and had no other risk factor for a major infection. A CT brain scan confirmed a frontal epidural abscess. The patient underwent emergency surgery for evacuation of the epidural abscess, followed by antimicrobial therapy. His condition improved remarkably following surgery, with complete resolution of symptoms. He subsequently underwent extraction of 2 teeth following dental review. Dental infection as a cause of intracranial epidural abscess is rare, but should be considered when evaluating patients for intracranial infections. A review of the literature sheds light on the causal relationship and possible pathogenesis of this condition. PMID:21361773

Kanu, Okezie Obasi; Ukponmwan, Efosa; Bankole, Olufemi; Olatosi, John Olutola; Arigbabu, Sarajudeen Oladele



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

PubMed Central

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.

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



Tropical liver abscess.  

PubMed Central

Forty-one consecutive cases of liver abscesses seen at the National University Hospital, Singapore from 1988 to 1994 were reviewed. Twenty-seven cases (65%) were pyogenic, six (15%) amoebic, two (5%) tuberculous and six (15%) indeterminate. The predominance of pyogenic abscesses is in marked contrast to previous studies from the region a decade ago in which amoebic abscesses were the commonest type. The commonest pathogen causing pyogenic abscess was Klebsiella pneumoniae. Two cases were due to Mycobacterium tuberculosis, and this organism needs to be actively looked for in smears and cultures of aspirated material. As the majority of organisms isolated were resistant to ampicillin, empirical antibiotic treatment for suspected pyogenic abscess should include gentamicin or a cephalosporin. Percutaneous needle aspiration of the abscess was performed for 85% of pyogenic abscesses and surgery was necessary in only two cases because of complications. We found that percutaneous aspiration of liver abscess is helpful to confirm the diagnosis, provides a better bacteriological culture yield, gives a good outcome, and may uncover clinically unsuspected conditions like malignancy and tuberculoma which may mimic the presentation of liver abscesses. We recommend routine cytological examination of aspirated abscess material as well as stains and cultures for acid-fast bacilli.

Yeoh, K. G.; Yap, I.; Wong, S. T.; Wee, A.; Guan, R.; Kang, J. Y.



Multiple listerial liver abscesses  

Microsoft Academic Search

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.

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



Achromobacter denitrificans renal abscess.  


We describe a case of a 66-year-old immunocompetent man affected by Achromobacter denitrificans renal abscess related to renal stones. The patient was treated successfully with meropenem 1 g three times daily for 60 days. To our knowledge, this is the first ever case reported of Achromobacter denitrificans renal abscess. PMID:22707140

Sgrelli, Alessio; Mencacci, Antonella; Fiorio, Maurizio; Orlandi, Cristina; Baldelli, Franco; De Socio, Giuseppe Vittorio Luigi



Clostridium perfringens sepsis and liver abscess following laparoscopic cholecystectomy  

PubMed Central

Clostridium perfringens sepsis with intravascular haemolysis is a catastrophic process with a reported mortality of between 90 to 100%. We successfully treated a case of severe clostridial infection with a liver abscess following laparoscopic cholecystectomy, the first to our knowledge. A 59-year-old man presented one week after an uneventful laparoscopic cholecystectomy with jaundice, peritonism, sepsis and acute renal failure. He was found to have a haemolytic anaemia, unconjugated hyperbilirubinemia and blood cultures grew Clostridium perfringens. A CT revealed a large gas forming abscess in the gallbladder fossa and right lobe of liver. He was treated with directed antibiotic therapy and underwent emergency laparotomy, drainage of the abscess and peritoneal washout. He required intensive care support, parenteral nutrition and inotropic support for a limited period. CT liver angiogram post op was normal. Continued renal dysfunction necessitated protracted haemofiltration. This resolved and the patient was discharged home at 2 months.

Qandeel, H; Abudeeb, H; Hammad, A; Ray, C; Sajid, M; Mahmud, S



Primary Ovarian Abscess in Pregnancy  

Microsoft Academic Search

Primary ovarian abscess is a rare entity, occurrence of ovarian abscess during pregnancy is even rarer. The clinical presentation is variable ranging from asymptomatic abscess to diffuse peritoni- tis. A delay in diagnosis may be detrimental to both mother and the fetus. We report a case of asymptomatic primary ovarian abscess associated with a term pregnancy.

N. Vimala; Nupur Kothari; Suneeta Mittal; Sunesh Kumar; Vatsla Dadhwal


Abscess in the Lungs  


... filling the space with pus, a condition called empyema. Very rarely, if an abscess destroys a blood ... STUDENT STORIES Pronunciations anesthesia bronchi bronchoscopy computed tomography empyema granuloma mucus periodontal pneumonia sarcoidosis Wegeners granulomatosis Back ...


[A Case of Culture-negative Brain Abscess Caused by Streptococcus intermedius Infection Diagnosed by Broad-range PCR of 16S Ribosomal RNA].  


Abstract A 50-year-old man presented with altered mental status during hospitalization for pneumonia. MRI showed multifocal ring-enhanced lesions, which consisted of multiple cerebral abscesses. We started empirical antibiotic therapy, but the following morning, his condition rapidly deteriorated and a CT scan revealed acute hydrocephalus, which required ventricular drainage. Gram staining of cerebro-spinal fluid from the ventricular drainage showed gram-positive cocci in chains, but culture results were negative. 16S ribosomal RNA sequencing with broad-range PCR of the cerebro-spinal fluid identified Streptococcus intermedius. On the basis of this identification, the antibiotic regimen was changed to ampicillin monotherapy. After 1 year of antibiotic therapy, all the abscesses had disappeared and the patient was discharged without any sequelae. Bacterial 16S rRNA gene analysis with broad-range PCR is a very useful method for facilitating the etiological diagnosis and selection of appropriate treatment for culture-negative infections. (Received: April 30, 2013, Accepted: June 11, 2013). PMID:24101431

Ohara, Nobuyuki; Asai, Katsunori; Ohkusu, Kiyofumi; Wakayama, Akatsuki



Pregnancy complicated by pelvic abscess.  


Tuboovarian abscess in pregnancy is a rare occurrence. The case presented and discussed is one in which a tuboovarian abscess was diagnosed and managed conservatively, with subsequent delivery of a viable infant. PMID:739481

Fuselier, P; Alam, A



Recurrent lingual abscess.  


Lingual abscess is an unusual condition but it may become a life-threatening entity. It presents as a very painful swelling of the tongue that, in its early stages, can be managed by antibiotic treatment. When the airway is obstructed, drainage is required by an open incision or aspiration with a large bore needle. We report a case who consulted on two occasions for a lingual abscess, which opened spontaneously. Due to the rarity of recurrent cases, the causes, diagnosis and treatments will be reviewed. PMID:21440238

Sánchez Barrueco, Álvaro; Melchor Díaz, Miguel A; Jiménez Huerta, Ignacio; Millán Juncos, José M; Almodóvar Álvarez, Carlos



First case of cerebral abscess due to a novel Nocardia species in an immunocompromised patient.  


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

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



Stereotactic biopsy and drainage of a brainstem abscess caused by Listeria monocytogenes.  


Listerial rhombencephalitis and brain abscesses are rare, but potentially life-threatening conditions. Early initiation of antibiotic therapy is crucial, but establishing the diagnosis of listerial brainstem abscess can be difficult. Stereotactic biopsy and drainage of space-occupying abscesses of the brainstem should be considered especially in cases of rapid clinical deterioration. We successfully performed stereotactic biopsy and drainage of a listerial brainstem abscess in a 42-year-old male patient who deteriorated despite antibiotic treatment, demonstrating that this approach is suitable in such patients. PMID:23615421

Beynon, Christopher; Neumann, Jan-Oliver; Bösel, Julian; Unterberg, Andreas W; Kiening, Karl L



A middle-aged lady with a pyogenic liver abscess caused by Clostridium perfringens  

PubMed Central

The pyogenic liver abscess caused by Clostridium perfringens (C. perfringens) is a rare, but rapidly fatal infection. It is usually associated with malignancy and immunosuppression. We report the case of 50-year-old lady with the secondary liver metastases from rectal cancer presented with fever and epigastric pain. The identification of Gram-positive bacilli septicaemia, the presence of gas-forming liver abscess and massive intravascular hemolysis should lead to the suspicion of C. perfringens infection. Here we review twenty cases published since 1990 and their clinical features are discussed. The importance of ”an aggressive treatment policy” with multidisciplinary team approach is emphasized.

Law, Siu-Tong; Lee, Ming Kai



Actinomycotic hepatic abscess  

Microsoft Academic Search

Actinomycotic hepatic abscess was diagnosed in a 46-year-old male driver from Ukraine presenting with the symptoms of malaise,\\u000a loss of appetite, upper right quadrant pain, weight loss, and night sweats which had been present for last 2 months. Computed\\u000a tomography (CT) of the abdomen revealed a hypodense mass in the left liver lobe which was suspected as hepatocellular carcinoma.\\u000a Histopathological examination

Arzu Tiftikci; Eser N. Vardareli; Kerim Kaban; Onder Peker; Sertac Akansel; Nurdan Tozun



Liver abscess in neonates  

Microsoft Academic Search

Introduction  Liver abscesses are rare in neonates with the majority resulting from an ascending infection via the umbilical and portal\\u000a veins, haematogenous spread, or via the biliary tree, or via direct contiguous spread from neighbouring structures. They may\\u000a present in unusual ways often presenting with ongoing sepsis and resulting in diagnostic difficulties. We present the clinical\\u000a and radiological findings on six

E. Simeunovic; M. Arnold; D. Sidler; S. W. Moore



[Spinal epidural abscess].  


The aspecific spinal epidural abscess is an uncommon cause of the spinal cord compression. Forty eight patients presented with epidural abscess were operated on during the last 37-year-period in the National Institute of Neurosurgery Budapest. Experiences with the diagnostic methods and the results of the treatment of these patients are analysed. Based on the case history data, preoperative symptoms and operative findings 31 male and 17 female patients (their age ranged from 15-64 years) have been selected in acute, subacute and chronic groups. Localized backpain, acceleration of the blood sedimentation, leukocytosis and fever were significant findings which were followed by sings of radicular or medullary compression. This clinical picture developed rapidly in the acute group. Aspecific abscess most commonly appeared in thoracal or lumbal localisation and was rarely found in the ventral area. Staphylococcus aureus was the causative organism in nearly 100 percent of the cases. Surgery carried out before the onset of the neurological deficits according to proper CSF examination and myelography, proved to be favourable. Early diagnosis and emergency operation led to a significant improvement of the outcome. PMID:7651713

Vidovszky, T



[An abscess in the tongue].  


Abscesses of the tongue are rare and potentially life-threatening because of risk of airway obstruction. It is most often preceded by trauma. In this paper we present an otherwise healthy patient with an abscess in the tongue eleven days after a trauma involving the presence of an insect believed to be a spider in the mouth. The symptoms were oedema, redness and pain of the tongue. A computed tomography was used as a diagnostic tool. The abscess was successfully treated with incision and antibiotics. Abscess should be considered as a differential diagnosis in patients presenting with a swollen tongue. PMID:23721846

Westergaard-Nielsen, Marie; Řstvoll, Eirik; Wanscher, Jens Hřjberg



Salmonella typhi rib osteomyelitis with abscess mimicking a 'cold abscess'.  


Salmonella enterica serovar typhi (Salmonella typhi) causing typhoid fever is common in many parts of the world particularly in developing countries. Extra-intestinal manifestations such as osteomyelitis are rare in immunocompetent individuals. We report a case of Salmonella typhi osteomyelitis of a rib with overlying abscess mimicking a 'cold abscess', treatment outcomes and discuss relevant literature. PMID:23853436

Mathuram, Alice; Rijn, Rianne Van; Varghese, George M



Intracerebral Aspergillus abscess: Case report and review of the literature  

Microsoft Academic Search

Intracranial aspergillosis is a rare pathologic condition, difficult to treat and often fatal, which generally affects immunodepressed patients. A case of brain abscess secondary to pulmonary localization in a patient with a non-Hodgkin lymphoma is described. The most significant clinico-pathological findings of intracranial aspergillosis are examined in the light of the relevant literature.

Marco Artico; Francesco S. Pastore; Maria Polosa; Shahram Sherkat; Massimiliano Neroni



CT Findings in Tuboovarian Abscess  

Microsoft Academic Search

Pelvic inflammatory disease with tuboovarian abscess can cause a wide range of radiologic abnormalities. Although the diagnosis of tuboovarianabscess is usually straighiforward and is based on clinical and sonographicfindings, unusualor unsus- pected cases may be confused with other pelvic or abdominal diseases. The purposeof this essay is to illustratethe CT findings in tuboovarian abscess.

Andrew C. Wilbur; Robert I. Aizenstein; Tracy E. Napp; Pictorial Essay


Hepatic Radioembolization Complicated by Abscess  

PubMed Central

Hepatic abscess is a rare complication of yttrium-90 radioembolization of hepatic tumors that most commonly occurs in patients with a history of biliary intervention. Patients usually present several weeks after therapy with pain, nausea, vomiting, and fever. Cross-sectional imaging is necessary in cases of suspected abscess to ensure prompt diagnosis and to help plan treatment, which involves antibiotics and percutaneous drainage.

Mascarenhas, Neil; Ryu, Robert K.; Salem, Riad



Management of pancreatic abscesses.  

PubMed Central

The records of twenty-one patients treated for pancreatic abscesses were reviewed. Pancreatitis developed following alcohol ingestion, operative procedures, biliary tract disease, ulcers, and undetermined causes. The clinical findings included abdominal pain in 19 patients (90%); fever in 18 (86%); tenderness in 18 (86%); and leukocytosis in 18 (86%). Ultrasonographic examination aided the diagnosis in seven of 11 patients. Computerized tomography was useful in diagnosing eight of ten cases. There were twenty-nine hospital admissions, with a mean length of hospitalization of 76 days per patient. The operative findings varied with extent and duration of underlying pancreatitis. The surgical approach depended on clinical presentation and prior localization of the abscess. Eleven additional operations were performed. Complications included respiratory failure (three patients); fistula formation (five patients); hemorrhage (two patients); renal failure (one patient); and splenic vein thrombosis (one patient). Thirteen patients were treated with hyperalimentation and nine patients had gastrostomy and jejunostomy placed for decompression and feeding. Of 15 patients in whom microbial studies were reviewed, nine patients had polymicrobial infections. Three patients had Candida albicans. There was one death. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 6.

Saxon, A; Reynolds, J T; Doolas, A



Ascaris liver abscess in children  

Microsoft Academic Search

Background  Liver abscess in childhood is a very challenging subject both for patients and doctors. In India, pyogenic liver abscesses\\u000a have been found mostly in children, especially in rural areas. Liver abscess due to wandering ascarids is a common complication\\u000a in children in Kashmir, although it is rare outside.\\u000a \\u000a \\u000a \\u000a Methods  The study was carried over a period of 10 years at Sheri-Kashmir

Shamsul Bari; Khurshid A. Sheikh; Mohammad Ashraf; Zahoor Hussain; Asif Hamid; Gowhar Nazir Mufti



Fungal splenic abscess.  


Nineteen patients with fungal splenic abscesses included 16 with leukemia, one drug user, one patient with Cushing's syndrome, and one without predisposing causes. Fifteen had persistent fever; six had esophageal or mucocutaneous candidiasis. Abdominal pain occurred in seven patients, splenomegaly occurred in six, and left abdominal mass occurred in one. Three chest x-ray films showed left pleural effusions; two had elevated left hemidiaphragms, two had left-sided infiltrates, and one was normal. Sixteen of 17 technetium Tc 99m sulfur colloid scans were abnormal, as were 15 gallium citrate Ga 67 scans. Two computed tomographic studies revealed splenic defects. Candida was the cause in 15 cases, Aspergillus was the cause in three cases, and Blastomyces dermatitidis was the cause in one case. Sixteen patients underwent splenectomy, 12 receiving postoperative antifungal therapy. Fifteen survived regardless of underlying disease or hepatic microabscesses. PMID:6385895

Johnson, J D; Raff, M J



Juxtapontine abscess around a retained wooden fragment following a penetrating eye injury: surgical management via a transtentorial approach.  


Penetrating injury through the orbit with a retained intracranial wooden foreign body is rare. The authors report the case of a child with a juxtapontine brain abscess secondary to a retained foreign body. The pitfalls in diagnosis and the surgical management for removal of the wooden fragment and drainage of the abscess are discussed. PMID:22208330

Gupta, Sunil K; Umredkar, Alok A



Computed tomography of tuboovarian abscesses.  


The CT findings of tuboovarian abscesses are described in three consecutive patients who had both CT and surgery. Computed tomography showed fluid-density adnexal masses having visible walls, septations, and indistinct borders, with anterior displacement of the mesosalpinx, hydroureter, and increased density of the fat and ligaments anterior to the sacrum. These findings are not specific but suggest the diagnosis of tuboovarian abscesses in an appropriate clinical context. PMID:2370362

Wilbur, A


Caruncular Abscess Due to Actinomycosis  

PubMed Central

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.

Lee, Yeon-Hee; Kim, Woo-Jin



Klebsiella pneumoniae liver abscess associated with septic spinal epidural abscess.  


A 56-year-old Japanese man with hypertension presented with a 10 days history of high fever, right and left upper quadrant tenderness. An abdominal ultrasonography and computerized tomographic scan revealed a large collection in the right lobe of the liver that was consistent with an abscess. A drainage catheter was placed and purulent fluid was drained. Cultures of the fluid and blood were positive for a strain of ampicillin-resistant Klebsiella pneumoniae. Six days after admission, paraplegia and urinary retention were found. On the neurological examination, deep tendon reflexes of the lower extremities were absent bilaterally. Magnetic resonance imaging scan detected thoracic spinal epidural abscess and paraspinal abscess. He received the emergent decompressive laminectomy. Culture of surgical specimen grew ampicillin-resistant K. pneumoniae. The patient was treated with biapenem intravenously. Thereafter, clinical symptoms improved gradually and he was removed to the professional hospital to continue rehabilitation for gait disturbance on hospital day 147. PMID:15652471

Kuramochi, Gen; Takei, Shin-Ichi; Sato, Munehiro; Isokawa, Osamu; Takemae, Takashi; Takahashi, Akira



Spinal epidural abscess in brucellosis.  


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

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



Tuboovarian abscess in the adolescent.  


Tuboovarian abscess is a serious consequence of pelvic inflammatory disease, especially in the adolescent population. Early diagnosis and treatment are essential to prevent further sequelae including infertility, ectopic pregnancy, and chronic pelvic pain. Not all patients, however, present with pelvic pain, pelvic mass, fever, and leukocytosis. We present the case of a sexually active 15-year-old black girl who presented with mild abdominal pain and excessive vaginal bleeding without pelvic mass, fever, or leukocytosis. Erythrocyte sedimentation rate was 66 mm/h. Pelvic ultrasound revealed bilateral complex ovarian masses. At laparoscopy, the patient had bilateral tuboovarian abscesses with extensive adhesions to the pelvic side walls. This case illustrates the need for a high index of suspicion of tuboovarian abscess in sexually active adolescents. PMID:9179805

Huang, A; Jay, M S; Uhler, M



[Lemierre's syndrome following peritonsillar abscess].  


Lemierre's syndrome is a rare but serious condition, characterized by disseminated infection with Fusobacterium necrophorum, most often originating from the oropharynx. Thrombophlebitis of the internal jugular vein and septic embolisms to various organs is the typical clinical picture. We describe a 16-year-old man with peritonsillar abscess who developed abscesses in lungs, liver and spleen. The patient was admitted to the ICU and treated with surgical drainage of infectious foci, antibiotics and anticoagulant therapy. After six weeks of antibiotic treatment the patient was discharged with no sequelae. PMID:22668650

Ehrenfried Berthelsen, Rasmus; Hein, Lars



Klebsiella pneumoniae liver abscess associated with septic spinal epidural abscess  

Microsoft Academic Search

A 56-year-old Japanese man with hypertension presented with a 10 days history of high fever, right and left upper quadrant tenderness. An abdominal ultrasonography and computerized tomographic scan revealed a large collection in the right lobe of the liver that was consistent with an abscess. A drainage catheter was placed and purulent fluid was drained. Cultures of the fluid and

Gen Kuramochi; Shin-ichi Takei; Munehiro Sato; Osamu Isokawa; Takashi Takemae; Akira Takahashi



Cholestasis in amoebic liver abscess  

Microsoft Academic Search

Two hundred and thirty six patients with amoebic liver abscess were investigated for cholestasis, its mechanism and the natural course of the disease. Cholestasis was seen in 29% of cases and it presented with some unusual features: it was frequently seen in young men (mean age 38.6 +\\/- 6.3 years) (87%) with acute onset (69%) and was associated with signs

P Nigam; A K Gupta; K K Kapoor; G R Sharan; B M Goyal; L D Joshi



Anorectal Infection: Abscess-Fistula  

PubMed Central

Anorectal abscess and fistula are among the most common diseases encountered in adults. Abscess and fistula should be considered the acute and chronic phase of the same anorectal infection. Abscesses are thought to begin as an infection in the anal glands spreading into adjacent spaces and resulting in fistulas in ~40% of cases. The treatment of an anorectal abscess is early, adequate, dependent drainage. The treatment of a fistula, although surgical in all cases, is more complex due to the possibility of fecal incontinence as a result of sphincterotomy. Primary fistulotomy and cutting setons have the same incidence of fecal incontinence depending on the complexity of the fistula. So even though the aim of a surgical procedure is to cure a fistula, conservative management short of major sphincterotomy is warranted to preserve fecal incontinence. However, trading radical surgery for conservative (nonsphincter cutting) procedures such as a draining seton, fibrin sealant, anal fistula plug, endorectal advancement flap, dermal island flap, anoplasty, and LIFT (ligation of intersphincteric fistula tract) procedure all result in more recurrence/persistence requiring repeated operations in many cases. A surgeon dealing with fistulas on a regular basis must tailor various operations to the needs of the patient depending on the complexity of the fistula encountered.

Abcarian, Herand



Solitary Abscess of the Brainstem.  

National Technical Information Service (NTIS)

A total of 38 reported cases of solitary abscess of the brainstem were studied. The route of infection may be direct extension usually from suppuration from the middle ear or hematogenous spread from a remote focus. In some instances, the route of infecti...

G. D. Weickhardt R. L. Davis



CT findings in tuboovarian abscess.  


As there are little data in the radiologic literature regarding the CT appearance of and the associated findings of tuboovarian abscesses (TOA), we retrospectively reviewed CT from seven patients with nine TOAs. They were bilateral in two patients and unilateral in the remaining five. The most common appearance of these abscesses was that of a somewhat tubular septated cystic pelvic mass with uniform wall thickness and with loss of fat planes between the mass and the adjacent pelvic organs (usually the uterus when present). Ipsilateral ureterectasis was also seen in four of nine lesions. Although these findings are not specific for TOA, they should be considered when pelvic masses having the above configuration are seen on CT. PMID:2061473

Ellis, J H; Francis, I R; Rhodes, M; Kane, N M; Fechner, K


Multicystic Hepatocarcinoma Mimicking Liver Abscess  

PubMed Central

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.

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



Cerebellar abscess. A review of 47 cases.  

PubMed Central

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.

Shaw, M D; Russell, J A



Primary retroperitoneal abscess caused by Candida glabrata.  


Clinically, retroperitoneal abscesses present insidiously and the diagnosis may be delayed. This, with inadequate drainage, may result in increased morbidity and mortality. Most cases result from a renal or gastrointestinal process, but in a small number of patients there is no identifiable source and the abscess is designated as "primary." Most retroperitoneal abscesses are polymicrobial, and cultures often reveal organisms such as Proteus mirabilis, Staphylococcus species, Peptostreptococcus, Enterococcus, Enterobacter, Escherichia coli and Bacteroides species. Fungal causes appear to be very rare, and in this study, a case of a patient with primary Candida glabrata retroperitoneal abscess is reported. PMID:22739567

Patel, Bhavin C; Wayangankar, Siddharth A; Ngo, Elizabeth; Chakrabarty, Shouvik; Bronze, Michael S




Microsoft Academic Search

Although amebic liver abscess can be a cause of significant morbidity and mortality in all ages, there are few reports dealing with this entity in children. Twenty-four children with amebic liver abscess. ages ranging between 8 weeks and 14.5 years were managed at the Tehran University Hospital of Children, Iran, between November 1987, and October 2001. The most frequent presentation

Z. Hadipoor; F. Hadipoor


Intramyocardial paravalvular abscess after aortic valve replacement.  


Myocardial abscess is a rare but life-threatening disease with various clinical presentations. We describe the case of a paravalvular abscess distending intramurally 7 years post surgery for aortic valve replacement. Early detection and urgent surgical intervention is essential for this otherwise fatal disease entity. PMID:23019986

Lutin, B; Van Belleghem, Y; Devos, D


Obturator internus muscle abscess in children.  


The authors describe four cases of obturator internus muscle (OIM) abscess in children, including their clinical presentations and treatment. This was a retrospective chart review. Children and adolescents younger than 18 years discharged between July 1, 1985, and September 30, 1998, from Brenner Children's Hospital with the diagnosis of muscle abscess or pelvic abscess were identified. A total of 56 patients were identified with the diagnosis of muscle abscess or pelvic abscess. OIM abscess was defined by radiologic findings of an inflammatory process with fluid collection in the OIM, along with the clinical findings suggestive of an OIM abscess. Four of the patients met the definition of OIM muscle abscess. The common presenting features were fever, limp, and hip pain. Computed tomography or magnetic resonance imaging was diagnostic in all four patients, and Staphylococcus aureus was the causative agent in each. All the patients recovered, one after surgical drainage and the other three after antimicrobial therapy alone or with needle aspiration. The presentation of OIM pyomyositis is similar to that of psoas muscle pyomyositis and other infectious processes of the pelvis and hip. The S. aureus is the most common etiologic agent but not the only one reported. Most patients can be managed without open surgical drainage, but needle aspirations may be helpful both therapeutically and diagnostically. PMID:11675547

Orlicek, S L; Abramson, J S; Woods, C R; Givner, L B


Oxygen fugacity of basaltic magmas and the role of gas-forming elements  

Microsoft Academic Search

It is suggested that major variations in the relative oxygen fugacity of a basaltic magma are caused primarily by gas-forming elements, especially carbon and hydrogen. According to this theory, carbon, present in the source region of a basaltic magma, reduces the host magma during ascent, as isothermally carbon becomes more reducing with decreasing pressure. For an anhydrous magma such as

Motoaki Sato



A 51-year-old man with intramedullary spinal cord abscess having a patent foramen ovale  

PubMed Central

The authors report a case of a 51-year-old man with intramedullary spinal cord abscess (ISCA) having a patent foramen ovale (PFO). He developed fever and tetraplegia after a recent dental treatment. MRI showed ISCA with longitudinal swelling from the upper cervical to the lumbar spinal cord. Cerebrospinal fluid (CSF) analysis indicated bacterial meningitis, and the culture of CSF revealed Streptococcus viridans. Transoesophageal echocardiography revealed the existence of a PFO. We suspected another possibility other than systemic bacteraemia, that paradoxical bacteric embolisation through PFO after the dental treatment caused ISCA. While several reports of brain abscess with PFO are available, this is the first report of ISCA with PFO.

Higuchi, Kanako; Ishihara, Hiroyuki; Okuda, Shiho; Kanda, Fumio





... covered to protect yourself from germs. Wash your hands often using plain soap and water for at least 20 seconds each time. It's OK to use alcohol-based instant hand sanitizers or wipes (the kind that you can ...




... immune system tries to fight it. White blood cells move through the walls of the blood vessels into the area of the infection and collect in the damaged tissue. During this ... cells, dead tissue, and bacteria or other foreign substances. ...




... aureus (CA-MRSA) is a strain of "staph" bacteria resistant to antibiotics in the penicillin family, which have been the ... infections in the general population. While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most staph infections with CA-MRSA can be ...


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


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

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



Variable CT appearance of hepatic abscesses  

SciTech Connect

Fifty computed tomographic (CT) scans in 33 patients with 37 separate episodes of hepatic abscess were reviewed retrospectively. Abnormalitites were detected in all but one case (97% sensitivity). The CT appearance of the lesions varied from well defined, rounded cavities with contents near water density, resembling poorly defined hepatic cysts, to higher-density foci indistinguishable from hepatic neoplasms. In only 19% was gas present within the abscess. Rim enhancement was seen in only 6%. This study suggests that CT is a sensitive test for detecting hepatic abscess but is often nonspecific.

Halvorsen, R.A.; Korobkin, M.; Foster, W.L.; Silverman, P.M.; Thompson, W.M.



Hepatic Abscess: Case Report And Review  

PubMed Central

Hepatic abscess is an uncommon occurrence in North America, but can be a diagnostic challenge for emergency department physicians. The clinical signs and symptoms may vary, leading to delays in diagnosis and higher morbidity. We present a case of a 35-year old male with a hepatic abscess initially misdiagnosed as pneumonia. On subsequent return to the ED for back pain complaints, a bedside ultrasound led to the appropriate diagnosis. This case report and discussion will attempt to review the literature on the etiology, diagnosis and treatment of hepatic abscess for the emergency physician.

McKaigney, Conor



Predictors of Primary Breast Abscesses and Recurrence  

Microsoft Academic Search

Background  We investigated the patients and microbiological risk factors that predispose to the development of primary breast abscesses\\u000a and subsequent recurrence.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients with a primary breast abscess requiring surgical therapy between January 1, 2000 and December 31, 2006 were reviewed.\\u000a Recurrent breast abscess was defined by the need for repeated drainage within 6 months. Patient characteristics were compared\\u000a to the general population

Ankit Bharat; Feng Gao; Rebecca L. Aft; William E. Gillanders; Timothy J. Eberlein; Julie A. Margenthaler



A case of thalamic abscess treated by endoscopic surgery  

Microsoft Academic Search

We report about a 7-year-old female child with cyanotic heart disease whose thalamic abscess was successfully treated by endoscope-assisted abscess drainage. Endoscopic as- piration of thalamic abscess appears to be a safe and effec- tive method of treatment for deep-seated abscesses, as di- rect visualization of the abscess cavity is possible and the completeness of evacuation can be assessed. to

Y. R. Yadav; Mufique Gajdhar



Diffusion MR imaging for cerebral abscess.  


We report a case of cerebral abscess, which ruptured into the lateral ventricle. The radiological features on conventional MRI, appearance on both diffusion weighted images (DWI) and apparent diffusion coefficient (ADC) maps are described. PMID:15626848

Jati, A; Venkatesh, S K; Patel, K; Malik, S



Pancreatic abscess secondary to Alcaligenes faecalis.  


We report a patient with pancreatic abscesses and necrosis secondary to Alcaligenes faecalis infection. He initially presented with alcohol-induced acute pancreatitis. Twenty days after the initial presentation, he re-presented with increasing pain and was found to have pancreatic necrosis and abscesses. Treatment was initiated with meropenem. Because of persistent fevers, computed tomography-guided drainage was performed. The fluid grew A faecalis resistant to meropenem and the patient continued to be febrile. He recovered only after adequate surgical intervention and appropriate antibiotic coverage. Although this is the first case of A faecalis reported to cause pancreatic abscess, we believe selection of this organism occurred because surgical drainage was delayed while the patient was on the recommended treatment with meropenem. This case emphasizes the need for early surgical drainage of pancreatic abscesses to avoid the selection of such resistant pathogens. PMID:15654182

Ashwath, Mahi Lakshmi; Katner, Harold P



[Diagnosis and treatment of peritonsillar abscess].  


Peritonsillar abscess (PTA) is a painful, deep infection. With appropriate treatment, complete resolution is usually achieved. Symptoms of PTA are, in most cases very typical, but diagnosis and especially locating the abscess cavity may be more challenging. Although any age group can be affected, PTA is most common in adolescents and young adults. Pus from the abscess cavity has to be removed with either needle aspiration, incision and drainage, or in conjunction with tonsillectomy. Antibiotics and pain killers are also required. Most cases can be treated as an outpatient. If inadequately treated abscess can spread to neck and mediastinum, and infection may require emergent surgical treatment. When adequate equipment and knowledge available, most PTAs can be managed in primary health care as well. PMID:20597330

Blomgren, Karin



Campylobacter upsaliensis isolated from a breast abscess.  

PubMed Central

Campylobacter upsaliensis is a rare human pathogen recovered so far only from stools or blood from patients with enterocolitis or bacteremia. We report the isolation of C. upsaliensis from a breast abscess.

Gaudreau, C; Lamothe, F



Endoscopically drained abdominal abscess compressing the sigmoid.  


Intra-abdominal abscesses (IAA) complicate numerous medical and surgical pathologic conditions. Accurate radiological diagnosis combined with percutaneous or surgical drainage and antibiotics is the current standard of care for IAA. We herein report a case of a 52-year-old woman with a 10-day history of fever and abdominal pain. An intra-abdominal abscess externally compressing the sigmoid was revealed and successfully drained during colonoscopy. PMID:22843307

Polymeros, Dimitrios; Sioulas, Athanasios D; Tsiamoulos, Zacharias; Kontopoulou, Christina; Giannitsioti, Efthymia; Triantafyllou, Konstantinos



[Computed tomography image analysis of peritonsillar abscess].  


The peritonsillar abscess (PTA) is one of the most common infectious diseases in the head and neck area and is treated with puncture, incision, or abscess tonsillectomy. In the present study, we performed a retrospective study for the patients who were diagnosed as having PTA on the basis of CT findings at the Kagoshima University Hospital between January 2007 and April 2012. The clinical characteristics were compared with the CT images and the indication of abscess tonsillectomy was discussed. In total, 145 patients (152 sides), mean age of 41 years (range: 5-80 years) were enrolled in the study. Patients having any surgical treatment such as puncture and incision before visiting our hospital were excluded. The CT findings revealed that PTA could be classified into two categories by the shapes of the abscess: the Oval type and Cap type. Further, the location of the abscess was differentiated superior and inferior, and classified into 4 categories: superior Oval type, superior Cap type, inferior Oval type, and inferior Cap type. The results showed that the number of the superior Oval type PTA was largest and followed by superior Cap type, inferior Cap type, and inferior Oval type in this order. When the CT classifications were compared with clinical findings, patients with the inferior Cap type abscess had laryngeal edema and airway obstruction more frequently than the other categories of PTA. Histological examination of the specimens obtained during surgery showed that the Cap type abscess tended to include more muscular tissue compared to the Oval type, indicating that inflammation might be more severe and wider in the Cap type than the Oval type. Those findings suggest that the inferior Cap type of PTAs need more intensive and reliable treatments such as abscess tonsillectomy. PMID:24044170

Ohori, Junichiro; Umakoshi, Mizuo; Miyashita, Keiichi; Hayamizu, Yoshiko; Harada, Mizue; Kurono, Yuichi



Interventional and surgical treatment of pancreatic abscess  

Microsoft Academic Search

Pancreatic abscess is one of the infectious complications of acute pancreatitis. It is a collection principally containing\\u000a pus, but it may also contain variable amounts of semisolid necrotic debris. Most of these abscesses evolve from the progressive\\u000a liquefaction of necrotic pancreatic and peripancreatic tissues, but some arise from infection of peripancreatic fluid or collections\\u000a elsewhere in the peritoneal cavity. Included

Kai Mithöfer; Peter R. Mueller; Andrew L. Warshaw



[Postappendectomy abscess--the role of fecoliths].  


Intraabdominal abscess formation is the most common septical complication after perforated appendicitis. An appendiceal fecalith favours appendicitis and is a high risk for complications like perforation or abscess formation. In a 6 year period 554 patients have been treated operatively for appendicitis in our institution. In 4 patients, 6 to 12 1/2 years, operated for perforated appendicitis, a fecalith was initially overlooked. This unrecognised fecalith at operation led to an intraabdominal abscess 14 days up to 17 months postoperatively. After laparatomy with extraction of the fecalith, drainage of the abscess and antibiotical therapy all patients attained definitive healing. An appendicolith can escape into the abdominal cavity before or during appendectomy, causing complications. An unrecognised fecalith is a rare cause for intraabdominal abscess formation. Nevertheless in patients with an intraabdominal abscess after appendectomy a thorough radiological search for a fecalith by means of plain abdominal radiograph and abdominal ultrasound is mandatory. Surgical removal of the intraabdominal fecalith is the only way to definitive healing. PMID:11678018

Horst, M; Eich, G; Sacher, P



Actinomycosis of the Brain  

PubMed Central

The available world literature (since Friedman's and Levy's comprehensive report in 1937) regarding actinomycosis of the central nervous system is reviewed. Only cases proved by culture were included in this analysis. A total of 17 cases was collected and an additional patient with this entity is described. The important differences between actinomycosis and nocardiosis are discussed. A definite diagnosis of actinomycosis was possible only when anaerobic cultures of cerebrospinal fluid or material obtained from a brain abscess yielded colonies of typical Actinomyces organisms. The characteristic result of infection of the brain by this fungus was abscess formation, and this occurred in all except one of the cases reviewed. Penicillin appears to be the drug of choice in treatment and, where possible, surgical excision of the cerebral abscess should be undertaken. ImagesFig. 1

Bolton, Charles F.; Ashenhurst, Edward M.



[A case of primary interhemispheric subdural abscess].  


A rare case of primary interhemispheric subdural abscess is reported. This 13 year old boy, who had had high fever for 2 days, was brought into the hospital by an ambulance. He was disoriented and mild stiffness of the neck was noted. A Jacksonian seizure that began in the left leg occurred immediately after admission. The initial CT scan showed no apparent abnormality. His clinical signs and spinal fluid findings showing slight monocytic response and normal sugar content suggested viral meningo-encephalitis. The patient was given steroid and glyceol to control the intracranial pressure and antibiotics was also given. The convulsions disappeared with anticonvulsants and the patient became afebrile on the 7th hospital day. He was discharged on the 53rd hospital day without any neurological deficit. But, he was re-admitted because of recurrence of the convulsion 29 days after the discharge. The CT scan revealed an interhemispheric (rt parafalcial) abscess and the drainage of abscess was performed through a craniotomy. The post-operative course was satisfactory and he was discharged on 33rd post-operative day. It is easy to diagnose the primary interhemispheric subdural abscess on CT scan at the advanced stage. However, it may be difficult to make definite diagnosis at its acute phase and it is important not to miss some characteristic clinical features of the interhemispheric abscess that can be safely cured by appropriate surgical treatment. PMID:3102987

Matsui, Y; Abekura, M; Yasuda, T; Yoshimine, T; Tanioka, T



Pathophysiology of jaundice in amoebic liver abscess.  


Jaundice in patients with amoebic liver abscess is a frequent occurrence. However, the pathophysiology of jaundice in these patients is not fully understood. Hepatic necrosis leads to damage to bile ducts as well as various vascular structures, which in turn leads to biliovascular fistula and jaundice. We studied the mechanism of jaundice in patients with amoebic liver abscess. We prospectively evaluated 12 patients with amoebic liver abscess and jaundice from February 2002 to August 2007. All patients underwent various investigations, including imaging studies. There were 11 males and 1 female patient with a mean age of 41.3 years. Mean duration of illness before presentation was 13.8 days. All patients had fever and jaundice. We detected damaged hepatic veins and bile ducts in all patients with amoebic liver abscess causing biliovascular fistula and hyperbilirubinemia, which reverted to normal after biliary diversion with nasobiliary drainage. Jaundice in patients with amoebic liver abscess is caused by biliovascular fistula resulting from hepatic necrosis leading to damage to bile ducts and hepatic veins. PMID:18385348

Singh, Virendra; Bhalla, Ashish; Sharma, Navneet; Mahi, Sushil Kumar; Lal, Anupam; Singh, Paramjeet



Amebic pericarditis following ruptured right liver lobe abscess.  


We present an unusual case of suppurative pericarditis following rupture of a solitary right lobe amebic liver abscess. The condition was treated successfully by drainage of the liver abscess alone. PMID:1916959

Supe, A N; Sathe, S S; Redkar, R G; Dalvi, A N; Kulkarni, B A; Shah, P P



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

Code of Federal Regulations, 2010 CFR

...2009-01-01 2009-01-01 false Abrasions, bruises, abscesses, pus, etc...CARCASSES AND PARTS § 311.14 Abrasions, bruises, abscesses, pus, etc. All slight, well-limited abrasions on the tongue and inner surface...



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

Code of Federal Regulations, 2010 CFR

...2010-01-01 2010-01-01 false Abrasions, bruises, abscesses, pus, etc...CARCASSES AND PARTS § 311.14 Abrasions, bruises, abscesses, pus, etc. All slight, well-limited abrasions on the tongue and inner surface...



Panspinal epidural abscess concomitant with meningitis.  


Panspinal epidural abscess is an extremely rare condition that can potentially lead to major permanent neurological deficits if treatment is delayed or suboptimal. Most patients with spinal epidural abscess have a short segment of vertebrae involved and classically present with fever, low back pain, and focal neurologic deficit. In severe cases, meningitis and septic shock may occur and lead to death. Therefore, the condition requires prompt recognition and proper intervention. Herein, we report the case of a 41-year-old diabetic man who presented at our hospital with the symptoms of headache, quadriplegia with respiratory distress and low back pain. Panspinal epidural abscess and meningitis were diagnosed by carrying out detailed neurologic examinations and neuroimaging studies, which expedited the correct diagnosis and treatment. PMID:23685059

Lin, Wen-Sou; Kao, Hung-Wen; Cheng, Chun-An



Evidence-based approach to abscess management  

PubMed Central

OBJECTIVE To provide family physicians with an overview of the evidence for managing superficial cutaneous abscesses. SOURCES OF INFORMATION PubMed (from 1950), EMBASE (from 1974), The Cochrane Library (from 1966), and Google (from 1998) were searched as were reference lists of identified articles. Summary sites, such as ACP Journal Club and InfoPOEMs, and background resources were also reviewed. MAIN MESSAGE There are many areas of debate regarding abscess management, including pain control, necessity of culture and sensitivity testing, empiric treatment with antibiotics, and open versus primary closure of wounds. Usefulness of cultures and empiric antibiotic treatment has risen to the forefront with the increasing incidence of community-acquired, methicillin-resistant Staphylococcus aureus. CONCLUSION In immunocompetent patients with no confounding risk factors, incision and drainage under local anesthetic is generally sufficient for abscess management. There is no compelling evidence for routine cultures or empiric treatment with antibiotics. Further research is required.

Korownyk, Christina; Allan, G. Michael



Unusual case of a lung abscess.  


A 56-year-old Caucasian lady presented with a short history of pleuritic chest pain on the background of a 2-month history of fever, chills, 10-kg weight loss and cough with brown sputum after a laparoscopic cholecystectomy. She had persistent eosinophilia and was diagnosed with a lung abscess as seen on chest x-ray. She did not respond to standard intravenous broad spectrum antibacterial medication and her chest CT scan showed a moderate pleural collection in continuity with the abscess. She also underwent bronchoscopy, the microscopy of the bronchial washings revealing eggs of the trematode Fasciola. The bacterial and fungal cultures of the washings were sterile. She had visited Turkey in the previous year but did not remember consuming any watercress or aquatic plants. She was successfully treated with two doses of the antiparasitic agent triclabendazole. Ectopic Fasciola can be a rare cause of a lung abscess. PMID:23595175

Musa, Duduzile; Godbole, Gauri; Chiodini, Peter L; Phillips, Russell



Retroperitoneal abscess from dropped appendicolith complicating laparoscopic appendectomy.  


Abscesses can occur after appendectomy. With the increasing use of laparoscopy, this risk has increased in the same way as the incidence of abscesses related to dropped gallstones increased after laparoscopic cholecystectomy. However, this occurrence has been rarely reported. We describe here the case of a young patient who developed retroperitoneal abscess one year after laparoscopic appendectomy. PMID:17503311

Lambo, A; Nchimi, A; Khamis, J; Khuc, T



Splenic abscess due to Staphylococcus lentus: a rare entity.  


Splenic abscess is an unusual condition, most often seen in immunocompromised patients. Splenic abscesses are due to aerobic and anaerobic bacteria, fungi and parasites, Staphylococcus aureus being the most common aetiological agent. We describe a case of splenic abscess in an alcoholic patient due to Staphylococcus lentus, a rare aetiology included in the microbiology of this disease. PMID:16857621

Karachalios, George N; Michelis, Fotios V; Kanakis, Konstantinos V; Karachaliou, Iris; Koutri, Rozetta; Zacharof, Antonios K



Tubo-ovarian abscess in the postmenopausal woman  

Microsoft Academic Search

Tubo-ovarian abscesses are considered a problem only during the childbearing years because of their rarity in the postmenopausal age group. Three case reports are described, in which pelvic abscesses were diagnosed in elderly women and necessitated surgical intervention. The early recognition and surgical treatment of pelvic abscesses is mandatory in the postmenopausal woman, who often is a poor-risk patient. Nothing

Zeev Blumenfeld; Chaim Toledano; Arieh Eitan; Ami Barzilai; Joseph M. Brandes



Current trends in the diagnosis and treatment of tuboovarian abscess  

Microsoft Academic Search

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

D. V. Landers; R. L. Sweet



MR of Multiple Intraspinal Abscesses Associated with Congenital Dermal Sinus  

Microsoft Academic Search

Summary: We describe the MR features in a case of multiple intraspinal abscesses involving almost the whole of the spinal cord in a 3-year-old child. The presence of a dermal sinus helped us in the preoperative diagnosis. Intramedullary spinal cord abscesses are un- common. When no demonstrable cause is present, they are referred to as primary abscess- es; when there

Ravi Dev; M. Husain; R. K. Gupta



[Minimally invasive surgery of liver abscesses].  


Results of the examination and treatment of 49 patients with abscesses of the liver are presented. Clinical-laboratory findings, specific features of localization, sizes and genesis of the disease are described. The criteria of the conservative and open surgical methods of treatment of abscesses of the liver are established, the advantages and shortcomings of USI for diagnosis of the disease are shown. An analysis of the data obtained allowed a conclusion that the percutaneous drainage under the ultrasonic control is an effective and perspective method of treatment, but requires further investigation, improvement and wide introduction into practice. PMID:14606156

Lazarenko, V A; Okhotnikov, O I; Chukhraev, A M; Istomin, S R; Tkacheva, V N



Rothia dentocariosa endocarditis and aortic root abscess.  


We report a case of endocarditis and associated paravalvular abscess due to Rothia dentocariosa which did not respond to antibiotic therapy. Nine case reports describing endocarditis caused by this organism, formerly thought to be non-pathogenic, have been recorded in the literature. The isolates were extremely sensitive to penicillin, and eight patients responded to this agent which, in most cases, was used in combination with an aminoglycoside. Surgery is recommended for an associated abscess, as the outcome in the two recorded cases has been fatal. PMID:9892536

Ferraz, V; McCarthy, K; Smith, D; Koornhof, H J



Psoas abscess complicating endovascular aortic aneurysm repair  

PubMed Central

Aortic stent graft infection is a rare but serious complication associated with high mortality. This report emphasizes the need for continued awareness of potential graft-related septic complications in patients undergoing Endovascular Aortic Repair (EVAR). We report a case in which a post-EVAR patient became unwell about 30 days post operatively and was shown on CT scanning to have a psoas abscess. The abscess was managed with percutaneous drainage and antibiotics. The patient remains well with no evidence of psoas collection or perigraft infection one year on. We review the available literature and discuss the merits of different management strategies.

Moussa, O; Sreedharan, L; Poels, J; Ojimba, T



Computed Tomography: Detecting Intra-Abdominal Abscesses  

PubMed Central

Detection of intra-abdominal abscesses by computed tomography (CT) has an estimated accuracy rate of greater than 90 percent. Features helpful in detecting these abscesses include extraluminal gas, the “rind” sign, airfluid interface, and low and high density areas. The author presents three cases to illustrate the usefulness of this modality. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 12Figure 13Figure 14Figure 15Figure 16Figure 17Figure 18Figure 19Figure 20

Stovall, Joyce Moore



Medical treatment of multiple streptococcal liver abscesses  

Microsoft Academic Search

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

Anne Matlow; Hillar Vellend



Spinal Epidural Abscess in a Young Child  

Microsoft Academic Search

This is a case report of a spinal epidural abscess, caused by Staphylococcus aureus, in a 3-year-old girl. The child presented with fever and hip pain, but without any neurologic deficit. After normal plain films and a normal bone scan were obtained, the diagnosis was made via magnetic resonance imaging (MRI). The neu- rosurgery and pediatric infectious disease teams evalu-

Megan H. Bair-Merritt; Charles Chung; Albert Collier


Breast Abscesses: Diagnosis, Treatment and Outcome  

PubMed Central

Background The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses treated at our institution in a multi-modality breast team, to determine whether minimally invasive treatments are successful. Methods 110 patients with mastitis and suspected breast abscesses at our institution between January 2000 and end of September 2007 were retrospectively analyzed. Abscesses were diagnosed using ultrasonography (US), and the material obtained using US-guided fine needle aspiration (FNA) was further examined. Results 29% of the patients were treated conservatively with antibiotics only, 51% were treated with US-guided FNA or drainage placement. 11% of the patients underwent additional surgery after minimally invasive treatment (i.e. conversion rate). 9% of the patients underwent primary surgery. Early complications occurred in 7% of patients treated minimally invasive but not in patients treated with surgery alone. Late complications occurred in 5% of patients who underwent minimally invasive treatments and in 30% of patients who underwent surgery. Conclusions US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective.

Fahrni, Markus; Schwarz, Esther I.; Stadlmann, Sylvia; Singer, Gad; Hauser, Nik; Kubik-Huch, Rahel A.



Epidural abscess caused by Mycobacterium abscessus  

PubMed Central

Summary Background: Mycobacterium abscessus is a member of the Rapidly Growing Mycobacterium (RGM). The incidence of Mycobacterium abscessus infections has steadily been increasing over the last decade. We report the case of an epidural abscess caused by Mycobacterium abscessus. RGM’s have infrequently been reported as spinal infections and we found no prior cases reporting M. abscessus as the definitive etiologic agent of an epidural abscess. Case Report: A 50 year old female presented with significant back pain and was found to have an epidural abscess by magnetic resonance imaging. The abscess was drained via needle. Initial cultures were negative for bacterial pathogens, and the patient was discharged to a skilled nursing facility for empiric antibiotic treatment. Eventually the culture grew Mycobacterium abscessus. The patient had unfortunately left the nursing facility and was lost to follow up. Conclusions: Mycobacterium abscessus is an increasingly recognized pathogen with particular risk factors that physicians should be aware of. Central nervous system infections are rare, but do occur. Treatment is difficult, though multiple antibiotic regimens have been reported successful. Surgical debridement is often needed.

Edwards, Charles; Diveronica, Matthew; Abel, Erika



Variable CT appearance of hepatic abscesses  

Microsoft Academic Search

Fifty computed tomographic (CT) scans in 33 patients with 37 separate episodes of hepatic abscess were reviewed retrospectively. Abnormalitites were detected in all but one case (97% sensitivity). The CT appearance of the lesions varied from well defined, rounded cavities with contents near water density, resembling poorly defined hepatic cysts, to higher-density foci indistinguishable from hepatic neoplasms. In only 19%

Robert A. Halvorsen; Melvyn Korobkin; William L. Foster; Paul M. Silverman; William M. Thompson



A rare cause of nasal septal abscess.  


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

Waterhouse, David; Hornibrook, Jeremy



Gallium-67 citrate imaging in subcutaneous abscess.  


The value of Ga-67 images in identifying unsuspected locations of subcutaneous Staphylococcus aureus abscess is presented. Many of the lesions detected on the Ga-67 study were not clinically evident. In addition, follow-up studies show resolution of the changes after antibiotic therapy. PMID:6580985

Sagar, V V; Martenz, D; Meckelnburg, R L



A vanishing liver abscess complicated with Klebsiella pneumoniae chest wall abscess: a case report.  


Septic metastasis is a unique feature of Klebsiella pneumoniae liver abscess in Taiwan. The case we report is a vanishing K. pneumoniae liver abscess with septic metastasis of the chest wall. The initial finding of a 36 year-old male with no previous medical history, was a huge hepatic mass presented on the sonography during a physical checkup. Hepatitis B, C serology, tumor markers and evidence of metastatic diseases were all negative. A computerized tomography examination was also inconclusive about its nature. Due to the patient's refusal of a liver biopsy, only oral antibiotics were medicated at the outpatient department. Unexpectedly, the follow-up computerized tomography, taken 4 weeks later, demonstrated that the liver mass was nearly absent, while a protruding painful lesion developed over the right chest wall. Under sono-guided aspiration, the chest wall mass was proved to be a pyogenic abscess. The Gram stain revealed gram-negative bacilli and the bacterial culture yielded K. pneumoniae. Under the impression of K. pneumoniae liver abscess with chest wall septic metastasis, after performing percutaneous drainage of the chest wall abscess, the patient was only given parenteral antibiotics for treatment. Both the liver and the chest wall abscesses were at last completely eradicated. PMID:10496167

Wang, Y Y; Lee, F Y; Chang, F Y; Lee, S D; Fung, C P



Isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus infection.  


We report a case of isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus (HIV) infection. A 30-year-old man presented to our outpatient department with sudden loss of visibility in his left visual field. He had no other systemic symptoms. Perimetry showed left-sided incongruous homonymous hemianopsia denser above the horizontal meridian. Magnetic resonance imaging revealed irregular well-marginated lobulated lesions right temporo-occipital cerebral hemisphere and left high fronto-parietal cerebral hemisphere suggestive of brain tubercular abscess. Serological tests for HIV were reactive, and the patient was started only on anti-tubercular drugs with the presumptive diagnosis of cerebral tubercular abscess. Therapeutic response confirmed the diagnosis. Atypical ophthalmic manifestations may be the initial presenting feature in patients with HIV infection. This highlights the need for increased index of suspicion for HIV infection in young patients with atypical ophthalmic manifestations. PMID:22824606

Gharai, Sujit; Venkatesh, Pradeep; Sinha, Anindita; Garg, Satpal; Ghosh, Prapti



Streptococcus intermedius causing infective endocarditis and abscesses: a report of three cases and review of the literature  

PubMed Central

Background Streptococcus intermedius is a member of the Streptococcus anginosus group. Clinical disease with S. intermedius is characterized by abscess formation and rarely endocarditis. Identification of Streptococcus intermedius is difficult, leading to the development of molecular methods to more accurately identify and characterize this organism. Case presentation Over a period of 6 months we encountered three cases of invasive Streptococcus intermedius infection presenting as hepatic abscesses, brain abscess, and endocarditis. We confirmed our microbiologic diagnosis through 16S sequencing and found a common virulence gene in each case. Conclusion Our report illustrates three different clinical manifestations due to Streptococcus intermedius infection that can be encountered in healthy individuals in a community hospital setting. To our knowledge, this is the first case of Streptococcus intermedius endocarditis confirmed by 16S sequencing analysis. The use of molecular methods may allow a better understanding of the epidemiology and pathogenesis of this organism.

Tran, MaryAnn P; Caldwell-McMillan, Molly; Khalife, Walid; Young, Vincent B



The role of percutaneous drainage of pancreatic abscesses.  


Pancreatic abscess remains the most lethal form of intra-abdominal abscess despite a wide variety of operative approaches that have been advocated for its control. Mortality is frequent, and recurrent abscesses after operative drainage are common. Death often results from ongoing uncontrolled sepsis. The role of percutaneous drainage (PCD) of pancreatic abscesses is controversial. Recent experience with five patients who had pancreatic abscess and in whom a combination of operative drainage and PCD proved instrumental in survival leads the authors to recommend the consideration of both forms of drainage dependent upon the circumstances. Specifically, indications for PCD may include the following: use as a temporizing measure prior to celiotomy in a critically ill patient; use in postoperative patients who have recurrent abscesses and in whom the presence of dense inflammation precludes safe evacuation of pus; and use in the patient who has known portal hypertension and in whom massive bleeding is likely to result from celiotomy and abscess drainage. PMID:3605866

Pickleman, J; Moncada, R



[Pulmonary abscess caused by fish bone].  


We describe an extremely rare case of pulmonary abscess caused by fish bone which stabbed the lung from transesophageal route. A 60-year-old woman referred to our hospital complaining of fever. Three days before, she had swallowing pain while eating the bony parts of a fish. An examination on admission showed that C-reactive protein (CRP) is 9.70 mg/dl. Chest computed tomography (CT)revealed, 4 cm mass shadow in the right upper lobe and fish bone material in the mass shadow. Esophagography showed no abnormal findings. Right upper lobectomy was performed under the diagnosis of pulmonary abscess by fish bone. Post operative course was uneventful. The cause was suspected of migration of a fish bone into the right upper lobe via mediasinum and thoracic cavity from esophagus. PMID:23445648

Matsuda, Eisuke; Okabe, Kazunori; Takahagi, Akihiro; Hayashi, Tatsurou; Tanaka, Toshiki; Sano, Fumiho; Tao, Hiroyuki



Right Ventricular Pneumocardia Secondary to Hepatic Abscesses.  


Gas-filled abscesses and gas gangrenes are extremely rare causes of intrahepatic gas. Even rarer, however, is the occurrence of gas within the non-portal hepatic veins. Most often seen in diabetic patients, dissemination and hepatic seeding of bacteria has been linked to procedures such as femoral catheters as well as liver lacerations and pyelonephritis. We report the case of a 69-year-old relatively healthy male who presented to our emergency department with abdominal pain and a fever of 103.3°F (39.6°C). A contrast-enhanced computed tomography scan of the abdomen revealed multiple hepatic abscesses and gas within the hepatic venous system as well as pneumocardia. In conclusion, gas within the non-portal hepatic veins is usually an indication of a serious underlying condition and its immediate identification is essential for treatment as hematogenous dissemination has already begun. PMID:21103210

Tichauer, Matthew; Sakpal, Sujit V; Chamberlain, Ronald S



[Microbial involvement in oral abscesses: update].  


Perioral abscesses are common manifestations of acute oral infections and microbiological studies has shown that they are polymicrobial infections, most often with the involvement of 3.5 different bacterial species. Microbial virulence, biocoenosis of oral cavity is elements which contribute to the emergence of oral infections. Although it may seem outside interest of dentist or oral surgeon updating related microbiological pathogens identified in perioral abscess, a brief and modest information about the profile of the pathogens involved is particularly beneficial and useful. The fact that this "explosive army" is not in sight, this not mean that it doesn't exist, so we believe that the holding of general notions of microbiological culture is necessary for prevention and treatment measures. PMID:20191908

Babiceanu, C; Voroneanu, Maria


Intradural extramedullary cysticercal abscess of spine  

PubMed Central

Neurocysticercosis (NCC) is one of the most common parasitic diseases affecting the central nervous system. Typically spinal NCC involvement has a concomitant cranial involvement. Spinal involvement by NCC, either intramedullary or extramedullary is very uncommon. The authors report a case of D12-L1 intradural extramedullary lesion in a 38-year-old female patient who presented with complaints of back pain and weakness of lower limbs. She underwent laminectomy and excision of the lesion. Histopathology revealed extramedullary cysticercal abscess. Post-operatively she was treated with albendazole. She had a successful recovery post-operatively and at 8 months follow up had no neurological deficits. This current case presents a very rare case of cysticercal abscess of dorsolumbar spine, without any evidence of cranial involvement. This report is to reemphasize the importance of including NCC as a differential diagnosis in intradural extramedullary lesion at the conus level in endemic areas like India.

Kapu, Ravindranath; Singh, Manish Kumar; Pande, Anil; Vasudevan, Matabushi Chakravarthy; Ramamurthi, Ravi



Breast abscess caused by penicillin resistant Pneumococci  

PubMed Central

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.

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



Right Ventricular Pneumocardia Secondary to Hepatic Abscesses  

Microsoft Academic Search

Gas-filled abscesses and gas gangrenes are extremely rare causes of intrahepatic gas. Even rarer, however, is the occurrence of gas within the non-portal hepatic veins. Most often seen in diabetic patients, dissemination and hepatic seeding of bacteria has been linked to procedures such as femoral catheters as well as liver lacerations and pyelonephritis. We report the case of a 69-year-old

Matthew Tichauer; Sujit V. Sakpal; Ronald S. Chamberlain



Splenic Abscess in a Tropical Zone  

PubMed Central

Abscess of the spleen is uncommon. The reported incidence varies widely and early observations of an association with tropical fevers are no longer evident. The pathogenesis is ill-understood and diagnosis is difficult and usually late. A careful clinical examination combined with the recent utilization of 99Technitium scanning and splenic arteriography now permit early diagnosis. Splenectomy is the treatment of choice. ImagesFigure 2

Ihekwaba, Frank N.



Citrobocter kasori spinal epidural abscess: a rare occurrence.  


Pyogenic spinal epidural abscess Is an uncommon Infectious occurrence. Clinical prospects of pyogenic spinal epidural abscess are graver if not promptly diagnosed and treated appropriately. A case of spinal epidural abscess has been presented with sinus tract formation at L4-L5 level, of pyogenic aetiology that progressed to paraplegia over the course of the disease. MRI pointed towards an epidural abscess extending from T12 vertebral level to S1 vertebral level. Surgical decompression in the form of laminectomy and evacuation of pus was done and antibiotics were given according to culture and sensitivity. Histopathological analysis revealed the acute suppurative nature of the abscess. Citrobacter kasori was isolated on pus culture. Pyogenic epidural abscess with causative organism being Citrobacter kasori has least been documented. PMID:24000517

Kumar, Ashok; Jain, Pramod; Singh, Pritish; Divthane, Rupam; Badole, C M



Psoas abscess formation in suboptimally controlled diabetes mellitus.  


Psoas abscess formation is a rare entity for which diabetes mellitus remains a major predisposing factor. Diabetes has long been associated with a predisposition to unusual and more serious infections. Here we present two cases that demonstrate that chronically suboptimally controlled diabetes remains an important marker for the development of primary psoas abscess. It is important to include psoas abscess in the differential in such patients to ensure early diagnosis and treatment. PMID:21811508

Lansdown, A J; Downing, A; Roberts, A W; Martin, D



Infected pseudocyst in tropical pancreatitis presenting as psoas abscess.  


Infected pseudocyst as a consequence of tropical pancreatitis presenting as psoas abscess is unusual. We report a 40-year-old man who presented with pain in the right lumbar region. CT and MRI of the abdomen revealed pancreatic pseudocysts with abscess formation in the psoas muscle and evidence of chronic calcific pancreatitis. He was managed by percutaneous drainage of the abscess along with antibiotics and other supportive measures. PMID:17090850

Harish, K; Thomas, Varghese; Kumar, Sunil; Jose, Tony


Paracoccidioides brasiliensis in a brain abscess: First French case  

Microsoft Academic Search

Paracoccidioides brasiliensis is a fungus geographically restricted to South America. Because of the long lasting evolution, imported cases of the disease could be diagnosed anywhere in immigrants. Cases remain actually rare in Europe: we report here the first case notified to the French National Reference Center for Mycoses.

D. M. Poisson; A. Heitzmann; C. Mille; B. Muckensturm; F. Dromer; B. Dupont; L. Hocqueloux



A nine month old child with retropharyngeal abscess secondary to mastoid abscess presenting as torticollis: a case report.  


We describe the unusual case of a 9-month-old Caucasian girl with a retropharyngeal abscess secondary to a mastoid abscess who presented with torticollis. The retropharyngeal abscess was caused by pus from the mastoid abscess tracking down under the petrous part of the temporal bone to reach the retropharyngeal space via the fossa of Rosenmüller. We believe that this is the first time that this route of infection has been reported. The patient was treated successfully with 7 days of intravenous ceftriaxone and flucloxacillin followed by oral co-amoxiclav for 7 days, followed by physiotherapy. PMID:19829809

Mydam, Janardhan; Thiagarajan, Prakash



Spinal Subdural Staphylococcus Aureus Abscess: case report and review of the literature  

PubMed Central

Background Only 65 cases (including our case) of spinal subdural abscesses have been reported to the literature, mostly to the lumbar spine. Staphylococcus aureus is the most common bacterial. The symptoms are not caracteristic and contrast – enhanced magnetic resonance imaging scan (MRI) is the imaging method of choice. The early diagnosis is crucial for the prognosis of the patient. Case presentation We present a patient 75 years old who had a history of diabetes and suffered acute low back pain in the region of the lumbar spine for the last 4 days before his admission to the hospital. He also experienced lower leg weakness, fever and neck stiffness. After having a brain CT scan and a lumbar puncture the patient hospitalized with the diagnosis of meningitis. Five days after his admission the diagnosis of subdural abscess secured with contrast – enhanced MRI but meanwhile the condition of the patient impaired with respiratory failure and quadriplegia and he was admitted to the ICU. A laminectomy was performed eight days after his admission into the hospital but unfortunately the patient died. Conclusion Early diagnosis and treatment are very important for the good outcome in patients with subdural abscess. Although morbidity and mortality are very high, surgical and antibiotic treatment should be established as soon as possible after the diagnosis has secured.

Velissaris, Dimitris; Aretha, Diamanto; Fligou, Fotini; Filos, Kriton S



[The role of echography in osteolytic tubercular abscesses].  


Tubercular abscesses are relatively common complications of tubercular spondylodiscitis. Fifty-one patients with suspected abscesses were selected from a group of 97 patients with tubercular spondylodiscitis and submitted to US. In 10 cases CT was performed before US and detected 7 abscesses, all of them confirmed by US. In the extant 41 cases, CT followed US; in 13 cases only US poorly visualized ilio-psoas muscles. As for the group of 23 patients who underwent both CT and US, if the former method is assumed as the reference gold standard, overall US sensitivity is 97% (1 false negative) and its specificity is 100%. In all cases where US findings were accurate and specific enough, CT was not performed; the patients were followed every seventh month and no abscesses found. US showed abscesses in the iliac fossa in 20 cases, along the psoas fascia in 6 and in the thighs in 3 cases. Two cases of gluteal localization were observed, together with 1 Grynfelt's triangle abscess, 1 Petit's triangle and 1 Scarpa's triangle abscesses; finally, 1 abscess was found in the knee. The most common appearance of tubercular abscesses is a hypoechoic and inhomogeneous pattern; sometimes caseum makes the abscess solid and hyperechoic. Calcifications were unusual in our series. All patients were submitted to percutaneous drainage under US guidance. The results proved US to allow the early and unquestionable diagnosis of tubercular abscesses and to confirm clinical suspicion. Moreover, US is also useful to guide percutaneous drainage and to follow the patients after drainage. As for CT, it remains the method of choice to depict vertebral involvement, but, in our series, it exhibited no significant advantages over US in the study of abscessual lumbar collections. PMID:8327758

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



Non-otogenic cerebral abscess1  

PubMed Central

Non-otogenic cerebral abscess is becoming relatively more frequent compared with otogenic. It arises in a setting of sepsis, trauma, or congenital heart disease. The onset presents a meningo-encephalitic picture, often with two stages, followed by epilepsy and/or a hemiparesis. The best investigations are an EEG and, probably, an isotope scan. The angiogram may be misleading as 40% may not have a midline shift. 'Acute localized non-suppurative encephalitis' seems to be more frequent than in the past. Antibiotics and aspiration appear to be the best treatment.

Martin, Graham



[Childhood laterocervical abscess fistulized in the pharynx: a case study].  


Cervical adenophlegmon is frequently encountered in children. We report on a case of an exceptional direct communication between a retropharyngeal abscess and a cervical adenophlegmon, observed in a 25-month-old child. Treatment comprised double antibiotic therapy and retropharyngeal drainage, which led to the subsidence of the laterocervical abscess. The progression was uncomplicated. PMID:19880296

Ondzotto, G; Fouemina, T; Oko, A; Akolbout, D; Itiere, F



Mastoid Abscess in Acute and Chronic Otitis Media  

PubMed Central

Background: Mastoid abscess remains a recognised complication of otitis media despite the advent of antibiotics. The objectives of this study were to describe the risk factors in patients with mastoid abscess following acute and chronic otitis media and discuss the management of this infection. Method: A retrospective analysis was done on all patients who underwent mastoidectomy for mastoid abscess from January 2002 to December 2007. Data on the patients’ presentation, associated complications, management, and follow-up were analysed. Results: A total of 12 patients were enrolled in this study population. Group A consisted of patients with mastoid abscess preceded by acute otitis media, while Group B consisted of patients with mastoid abscess and chronic otitis media. In Group A (n = 7), 4 patients had a pre-morbid immunocompromised condition, but they did not have cholesteatoma. None of the patients in Group B (n = 5) had any pre-morbid illnesses. Out of 12 patients, 7 patients had associated extracranial complications, and 1 patient had intracranial complications. Most patients recovered well after mastoidectomy. Recurrence was noted in 1 patient who had acute lymphoblastic leukaemia. Conclusion: Mastoid abscess is still a recognised complication of acute otitis media, especially in patients who are immunocompromised. Immunocompetent patients may also develop mastoid abscess following chronic otitis media associated with cholesteatoma. Thus, early treatment of otitis media and close vigilant follow-up are advocated to ensure prompt detection of mastoid abscess complications.

Ami, Mazita; Zakaria, Zahirrudin; Goh, Bee See; Abdullah, Asma; Saim, Lokman



Roseomonas spinal epidural abscess complicating instrumented posterior lumbar interbody fusion.  


The first case of a spinal epidural abscess caused by Roseomonas mucosa following instrumented posterior lumbar fusion is presented. Although rare, because of its highly resistant profile, Roseomonas species should be included in the differential diagnosis of epidural abscesses in both immunocompromised and immunocompetent hosts. PMID:23596239

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



Liver Abscesses in Feedlot Cattle: A Review1,2  

Microsoft Academic Search

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

T. G. Nagaraja; M. M. Chengappa



Klebsiella pneumoniae isolates causing liver abscess in Taiwan  

Microsoft Academic Search

Klebsiella pneumoniae has been the leading cause of pyogenic liver abscess in Taiwan during the period from 1985 to 1999, which is different from other countries. The present study investigated the in vitro antimicrobial susceptibilities of 51 K. pneumoniae isolates collected from blood cultures of patients with liver abscess in Taiwan during the period from 1993–1997, and typed by pulsed-field

Shan-Chwen Chang; Chi-Tai Fang; Po-Ren Hsueh; Yee-Chun Chen; Kwen-Tay Luh



Post-partum pyogenic abscess containing Ascaris lumbricoides.  


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

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



Bartholin's gland abscess in a neonate: a case report  

PubMed Central

Bartholin's gland abscesses are extremely rare in prepubertal girls. A literature search revealed that only 3 cases have been reported in infancy and that 1 case has been reported in a neonate. We report the second case of a Bartholin's gland abscess in a female neonate.

El Kady, Sherif; Jednak, Roman; El Sherbiny, Mohamed



Parotid abscess in a late premature infant: a case report.  


Parotid abscess is uncommon in neonates. It is frequently related to prematurity, prolonged gavage feeding and dehydration. We report a case of a late preterm infant who developed the classical manifestation of unilateral acute Staphylococcus aureus suppurative parotitis progressing to formation of abscess which responded to surgical drainage and antibiotic therapy. PMID:23770964

Zurina, Z; Wong, H L; Jasminder, K; Neoh, S H; Cheah, I G S



A novel vaccine targeting Fusobacterium nucleatum against abscesses and halitosis  

Microsoft Academic Search

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

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



Candida lung abscesses in a renal transplant recipient.  


We herein report a renal allograft recipient five years post transplant who had bilateral lung abscesses. The abscess grew Candida tropicalis on bronchoalveolar lavage. The patient was administered amphotericin B, but succumbed to massive hemoptysis. The case highlights a fungal complication in renal transplant and need for early suspicion and prompt therapy. PMID:23538356

Gupta, Ankur; Bhowmik, Dipankar M; Dogra, Pavitra M; Mendonca, Satish; Gupta, Amit



Nursing care of a patient with a subphrenic abscess.  


A subphrenic abscess is an abscess which forms below the diaphragm and above the transverse colon. Patients in the postoperative period following gastric, esophageal or hepatic surgery are at risk of developing a subphrenic abscess especially if they are older, if they develop a leak at an anastomosis site or if there was a high operative blood loss. Nurses who are aware of high-risk patients should increase their observations of the signs and symptoms of early subphrenic abscess. Subphrenic abscesses are often managed on the general nursing units but signs of impending respiratory failure or circulatory collapse may warrant transfer of the patient to an intensive care unit. Nursing interventions are then focused on maintaining the body systems, evaluating the effects of the medical and nursing interventions and supporting the patient and family who may be very anxious at the severity of the unanticipated complication. PMID:2598106

Beckermann, S; Galloway, S C


Orthodontic Elastic Separator-Induced Periodontal Abscess: A Case Report  

PubMed Central

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

Becker, Talia; Neronov, Alex



Tuboovarian abscess mimicking malignancy: report of two cases.  


Tuboovarian abscess is a well-known sequela of acute or chronic salpingitis. In a small percentage of patients, these inflammatory masses compress or even rupture into the adjacent viscera, thus simulating the condition of pelvic malignancy, particularly when the clinical presentations are indolent. We describe two cases of tuboovarian abscess mimicking malignancy. Case 1: A 39-year-old woman with an intrauterine device had a clinical presentation mimicking an exophytic submucosal colorectal tumor with suspicious mucosal invasion. She complained of tenesmus but did not experience fever or adnexal tenderness. A right tuboovarian abscess with fistula formation into the rectosigmoid colon was noted during laparotomy. Case 2: A 46-year-old woman with an intrauterine device had a preoperative diagnosis of uterine myoma with degeneration. At laparotomy, an omentum cake with dense pelvic adhesions was noted. Malignancy appeared to be present, and debulking surgery was performed. The final pathologic examination revealed bilateral chronic tuboovarian abscesses and focal omental abscess. PMID:11061074

Chow, S N; Chen, M



Orthodontic elastic separator-induced periodontal abscess: a case report.  


Aim. Orthodontic elastic bands were proposed as being the source of gingival abscesses that can rapidly lead to bone loss and teeth exfoliation. We report an adolescent, otherwise, healthy patient whose periodontal status was sound. Shortly after undergoing preparations for orthodontic treatment consisting of orthodontic separators, he presented with a periodontal abscess for which there was no apparent etiology. A non-orthoradial X-ray was inconclusive, but an appropriate one revealed a subgingival orthodontic separator as the cause of the abscess. Removal of the separator and thorough scaling led to complete resolution of the abscess, but there was already residual mild damage to the alveolar bone. Summary. Failure to use appropriate imaging to reveal the cause of gingival abscesses can result in the delay of implementing treatment and halting irreversible alveolar bone loss. An inflammatory process restricted to the gingiva and refractive to conventional therapy should raise the possibility of a foreign body etiology. PMID:22567456

Becker, Talia; Neronov, Alex



A play in four acts: Staphylococcus aureus abscess formation.  


Staphylococcus aureus is an important human pathogen that causes skin and soft tissue abscesses. Abscess formation is not unique to staphylococcal infection and purulent discharge has been widely considered a physiological feature of healing and tissue repair. Here we present a different view, whereby S. aureus deploys specific virulence factors to promote abscess lesions that are distinctive for this pathogen. In support of this model, only live S. aureus is able to form abscesses, requiring genes that act at one or more of four discrete stages during the development of these infectious lesions. Protein A and coagulases are distinctive virulence attributes for S. aureus, and humoral immune responses specific for these polypeptides provide protection against abscess formation in animal models of staphylococcal disease. PMID:21353779

Cheng, Alice G; DeDent, Andrea C; Schneewind, Olaf; Missiakas, Dominique



A play in four acts: Staphylococcus aureus abscess formation  

PubMed Central

Staphylococcus aureus is an important human pathogen that causes skin and soft tissue abscesses. Abscess formation is not unique to staphylococcal infection and purulent discharge has been widely considered a physiological feature of healing and tissue repair. Here we present a different view, whereby S. aureus deploys specific virulence factors to promote abscess lesions that are distinctive for this pathogen. In support of this model, only live S. aureus are able to form abscesses, requiring genes that act at one or more of four discrete stages during the development of these infectious lesions. Protein A and coagulases are distinctive virulence attributes for S. aureus, and humoral immune responses specific for these polypeptides provide protection against abscess formation in animal models of staphylococcal disease.

Cheng, Alice G.; DeDent, Andrea C.; Schneewind, Olaf; Missiakas, Dominique



[Splenic abscess and cat-scratch disease].  


Cat-scratch disease is caused by a Gram-negative bacillus known as Bartonella henselae. This disease is usually benign and causes regional adenitis that does not require treatment. However, some patients develop more serious atypical forms of the disease including prolonged systemic illness with hepatic and splenic abscesses.A 14-year-old girl was admitted to hospital with a 12-day history of persistent high fever and abdominal pain. Ultrasonography and computerized tomography of the abdomen revealed splenic abscesses. These findings, together with an antecedent of cat exposure, led to the suspicion of cat-scratch disease, which was confirmed by serology. The girl was treated with intramuscular ceftriaxone and clinical evolution was favorable. Splenic cat-scratch disease is infrequent. Cat-scratch disease sometimes presents as fever of unknown origin and consequently this disease should be considered in the differential diagnosis of prolonged fever. Although evolution is usually favorable, antibiotic therapy is recommended in systemic manifestations of cat-scratch disease. PMID:11578546

Valdesoiro Navarrete, L; Pineda Solas, V; Martín Martín, C; Sanfeliu Sala, I; Cabezas Maspoch, R M; Sánchez Oespina, M



Bilateral psoas abscess during pregnancy presenting as an acute abdomen: atypical presentation.  


Nearly half of skeletal tuberculosis patients have spinal tuberculosis, but psoas abscess develops in only 5% of spinal tuberculosis cases. However, bilateral psoas abscess is a rarity. Psoas abscess occurring in pregnancy could be a clinical dilemma and is hardly reported. We report an unusual presentation of bilateral psoas abscess in pregnancy presenting as an acute abdomen and adnexal mass. PMID:24148941

Nigam, Aruna; Prakash, Anupam; Pathak, Puja; Abbey, Pooja



Surgical Treatment of a Tuberculous Abscess of the Chest Wall  

PubMed Central

Background Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management. Materials and Methods Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively. Results Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases. Conclusion Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.

Kim, Jae-Bum; Park, Chang-Kwon



Transurethral Drainage of Prostatic Abscess: Points of Technique  

PubMed Central

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.

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



Concomitant tubercular and fungal cerebellar abscess in an immunocompromised girl.  


Concomitant tubercular and fungal cerebellar abscess is rare and we report the first concomitant recurrent multi-lobulated tubercular and fungal cerebellar abscess in an immunocompromised girl with Histiocytosis-X. She presented with cerebellar abscess history diagnosed during the ongoing treatment for tuberculous meningitis. The abscess was drained. Upon the detection of cerebellar abscess recurrence and pulmonary infection, she was referred to our clinic five weeks after the first surgical intervention. Patient was conscious, co-operating but confused. She had severe cachexia, stiff neck and fever. Fundus examination showed bilateral papilledema. Cranial MR images revealed multiple lobulated lesions. Suboccipital craniectomy was performed and abscess was evacuated in toto. Lesion was multi-lobulated. Thick, yellow-gray purulent material was drained. Histopathological examinations yielded Langhans giant cells,budding and branching fungal structures. Fungal infection was identified. We emphasize that posterior decompression and total resection should be considered first in the management of lesions with mass effect in the posterior fossa. Also the presence of concomitant fatal fungal abscess highlights that although the clinic and former diagnoses of the patient may direct the clinician to a certain pathogen, unusual resistant organisms should not be. PMID:23344873

Simsek, Hakan; Kutlay, Murat; Colak, Ahmet; Haholu, Aptullah; Kaya, Hatice; Ozyurt, Mustafa; Demircan, Mehmet Nusret



Penetration of the blood–brain barrier by Staphylococcus aureus : contribution of membrane-anchored lipoteichoic acid  

Microsoft Academic Search

Staphylococcus aureus is one of the most prevalent organisms responsible for nosocomial infections, and cases of community-acquired S. aureus infection have continued to increase despite widespread preventative measures. Pathologies attributed to S. aureus infection are diverse; ranging from dermal lesions to bacteremia, abscesses, and endocarditis. Reported cases of S. aureus-associated meningitis and brain abscesses have also increased in recent years,

Tamsin R. Sheen; Celia M. Ebrahimi; Ida H. Hiemstra; Steven B. Barlow; Andreas Peschel; Kelly S. Doran



Cecal Fibromatosis (Desmoid Tumor) Mimicking Periappendicular Abscess: A Case Report  

PubMed Central

A 32-year-old man presented to our department with abdominal pain and fever. In an earlier hospitalization he was diagnosed with periappendicular abscess and treated with antibiotics. Due to fever and ‘non-resolution’ of the abscess and due to its deep location in the lower abdomen, which excluded percutaneous drainage, we elected to operate the patient. A large mass in the cecum accompanied with an abscess resulted in a right hemicolectomy. The pathological examination revealed a desmoid tumor of the cecum. The patient's recovery was uneventful.

Peled, Zvi; Linder, Revital; Gilshtein, Haim; Kakiashvili, Eli; Kluger, Yoram



Bowel-related abscesses: MR demonstration preliminary results.  


The purpose of this study is to describe the appearance of bowel-related abscesses on magnetic resonance (MR) images. Sixteen consecutive patients who had bowel-related abscesses underwent MR examination at 1.5T. MR sequences included T1-weighted fat-suppressed imaging pre- and post-intravenous gadolinium chelate administration (all patients) and breathing-independent single-shot T2-weighted half Fourier turbo (fast) spin echo (6 patients). Patients with pelvic abscesses also underwent sagittal imaging with post-gadolinium T1-weighted images (9 patients) and T2-weighted turbo (fast) spin echo (8 patients). Abscesses were confirmed by open surgery or surgical drainage (6 patients), percutaneous drainage (8 patients), or combined physical examination, fluoroscopic fistulogram, and clinical follow-up (2 patients). Oval-shaped fluid collections were identified in all of the patients, which ranged in diameter from 2 cm to 18 cm, mean: 8 cm. Abscesses were low to intermediate in signal on T1-weighted images, heterogenous and moderately high signal on T2-weighted images, and low signal on post-gadolinium images. A layering effect of lower signal material in the dependent portion of the abscess was noted in abscesses in 6 of 14 patients on T2-weighted images. Post-gadolinium images demonstrated a definable 3- to 7-mm thick abscess wall, which enhanced substantially with contrast. Definition of the wall was best shown on fat-suppressed images post-gadolinium. Substantial enhancement of surrounding periabscess tissues was demonstrated in all cases and was most clearly defined on fat-suppressed images. Image acquisition in two orthogonal planes was of value to demonstrate that fluid collections were oval, and separate from bowel. Image acquisition in the sagittal plane was useful in the evaluation of pelvic abscesses. The results from this preliminary study show that bowel-related abscesses are demonstrable on MR images using gadolinium-enhanced fat-suppressed T1-weighted and turbo (fast) spin-echo T2-weighted sequences. The presence of a thickened, enhancing lesion wall and enhancement of perilesional tissues on T1-weighted fat-suppressed images were observed in all abscesses. A layering effect of low signal intensity material in the dependent portion of the abscess was an important ancillary feature. PMID:9814766

Semelka, R C; John, G; Kelekis, N L; Burdeny, D A; Worawattanakul, S; Ascher, S M



[Intradural extramedullary tuberculous abscess. Apropos of a case].  


Intradural extramedullary tuberculous spinal abscess is rare and has a poor prognosis if not diagnosed early and treated adequately. We report the case of 13 year-old boy who presented with an 8-month history of paraplegia. MR imaging demonstrated an intradural extramedullary spinal abscess in the mid-thoracic region. At operation, an encapsulated abscess was removed completely. The tuberculous nature was confirmed with microbiological testing. Postoperative antituberculous chemotherapy resulted in complete recovery. MR imaging can prove very helpful in early diagnosis of this condition, which is particular relevant in countries where tuberculosis is endemic. PMID:9161538

Achouri, M; Hilmani, S; Sami, A; Ouboukhlik, A; el Kamar, A; el Azhari, A; Boucetta, M



Colonic diverticular abscess presenting as chronic diarrhea: a case report  

PubMed Central

Introduction Several complications have been reported with diverticular disease of colon. Perforation of the diverticulum of colon may lead to development of abdominal abscesses which can have diverse manifestations. Case presentation This report describes a 72 year-old woman presented with a one month history of non-bloody diarrhea, abdominal pain, and low grade fever. Computed tomography scan confirmed presence of a large local air-fluid level within the culdesac area. Laparotomy revealed a large pelvic abscess which was surrounded between rectosigmoid and uterus with severe tissue necrosis of rectosigmoid colon and uterus. Conclusion Although rarely reported, abdominal abscesses due to colonic diverticulitis may present as refractory chronic diarrhea.



[Splenic abscess as an unusual manifestation of colonic carcinoma].  


A patient was admitted to the Internal Medicine Department after suffering from fever for 4 days. A splenic abscess was found in an ultrasound examination and was confirmed by an abdominal computerized tomography and galium scan. Antibiotic treatment was successful, however barium enema was performed due to the lack of a predisposing factor for this unusual abscess. A polypoid mass was found in the splenic flexure of the colon. Colonoscopy and histologic examination confirmed the mass to be colonic adenocarcinoma. Either an endoscopic examination or barium enema are recommended to exclude colonic lesions in cases of splenic abscess without an obvious cause. PMID:11944213

Leibovitz, Ilan; Polychuck, Ilia; Reitblat, Tatiana; Gheorghiu, David; Zamir, Doron



Cholecystocutaneous abscess: diagnostic difficulty in a groin lump.  


An older patient presented with a 4-week history of tender lump in the right groin. Appearances were consistent with strangulated inguinal hernia and theatre was arranged. At operation, the lump was found to be an abscess communicating with the abdominal cavity. Alternative diagnosis requiring further operative management was considered but consent was deemed inadequate to proceed. Operation was abandoned and CT examination arranged. CT unexpectedly identified a cholecystocutaneous abscess discharging through the right inguinal region. The patient made good clinical recovery with ongoing drainage of the abscess and did not require any further operative treatment. PMID:22744248

Geraghty, Alistair; Kettlewell, Sally; Arestis, Nik



[Psoas abscess as a chicken pox complication].  


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

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



Injection site abscesses caused by Mycobacterium chelonei.  


Subcutaneous abscesses occurred at hip and deltoid injection sites in 13 student nurse assistants following practice injections. Mycobacterium chelonei was isolated from three cases and was the presumptive pathogen in other temporally clustered cases with similar clinical findings. A 1,000 cc bottle of 0.9 N saline used as a source for practice injection solution was the apparent source of the organism. Presenting findings included tenderness (7), swelling (7), fever (3), adenopathy (1) and weight loss (1). All cases were characterized by long incubation periods (6 to 16 weeks) and delayed resolution (mean 8.8 months), and required surgical drainage or wedge excision for therapy. Antituberculous therapy was administered in three cases. Complications were limited to scarring in seven cases with keloid formation in two and persistent pain in three cases. This outbreak reinforces the importance of penetrating trauma in this cutaneous mycobacterial infection and emphasizes the emergence of this organism as an important nosocomial pathogen. PMID:6550577

Gremillion, D H; Mursch, S B; Lerner, C J


Intra-Abscess Administration of Antibiotics Through Ultrasound-Guided Percutaneous Catheter for the Treatment of Pyogenic Liver Abscess  

PubMed Central

Pyogenic liver abscess is a potentially life-threatening disease. The treatment of a pyogenic liver abscess usually involves ultrasound guided percutaneous drainage because of the poor penetration of the systemic administration of antibiotics inside the abscess. However, a sizable proportion of patients will necessitate surgical interventions, which involves high peri- and post-operative risks. Theoretically, the local instillation of antibiotics inside the pyogenic liver abscess fluid could achieve a high concentration of the antibiotic for a long period of time. This could be especially beneficial for time-dependent bactericidal antibiotics such as beta-lactams, because their bactericidal effectiveness depends on the amount of time that bacteria are exposed to the antibiotic. We are reporting two patients with complicated pyogenic liver abscesses, who were successfully treated with systemic antibiotics and local instillation of meropenem inside the cavities of the abscesses. These cases suggest that the local instillation of the beta-lactam antibiotics could be an effective and a safe strategy for the treatment of pyogenic liver abscesses that cannot be completely drained through an ultrasound guided percutaneous catheter.

Alvarez-Uria, Gerardo; Pakam, Raghavakalyan; Midde, Manoranjan; Naik, Praveen Kumar



An unusual causative agent for an orbital abscess: Granulicatella Adiacens.  


We present a patient who developed an orbital abscess secondary to a retained organic (wooden) foreign body after a fall. Clinically, he had a right sub brow fistula exuding purulent discharge, four millimetres of proptosis, limitation of ocular motility in all directions of gaze, but no signs of optic neuropathy. Preoperative computed tomography and magnetic resonance imaging of the orbits was performed to localise the abscess and to facilitate surgical planning. He underwent exploration, drainage of the abscess and removal of the wooden foreign body with good postoperative recovery. Cultures isolated Ganulicatella Adiacens, a nutritionally variant streptococcus. This is an unusual causative organism and to our knowledge, this is the first reported case of a posttraumatic orbital abscess associated with Granulicatella Adiacens. Clinical suspicion, isolation of the organism and appropriate microbial treatment requires a multidisciplinary approach, with input from the ophthalmologist, microbiologist and infectious disease team. This will ensure a good outcome in patient management. PMID:21574808

Teo, Livia; Looi, Audrey; Seah, Lay Leng



[Abscess of the posterior cranial fossa. Apropos of 10 cases].  


In this study, a series of 10 cases of abscess of the posterior cerebral fossa is analysed. In our department, the incidence of this condition is 2 cases per year. These predominantly occur in juvenile male and are frequently caused by adjacent ENT disease. Numerous therapeutic approaches are possible. In our series, 3 patients underwent emergency surgery with simultaneous treatment of the abscess of the ear. A second series of 6 patients underwent delayed treatment of the ENT infection (over 2 weeks) after the emergency puncture of the abscess. The rapid and good recovery of the 3 patients who underwent simultaneous petromastiodectomy and puncture of the abscess during surgery should be emphasized. PMID:8377885

Ouboukhlik, A; el-Kamar, A; el-Azhari, A; Boucetta, M; Benchekroun, Y



Recurrent intraabdominal abscess caused by Salmonella paratyphi C.  

PubMed Central

We describe a patient who suffered from recurrent intraabdominal abscesses. The last two of the three abscesses were certainly caused by Salmonella paratyphi C. The time interval between the first and the second abscess was 25 years, and that between the second and the third abscess was 20 years. Single infection with this microorganism is very rare in Israel, with only four known cases in the last 20 years. The annual frequency in the United States is 0 to 2 cases per year. In recent years, this infection has also been very rare in other parts of the world. Our case is unique as it recurred two or three times. The infection was probably dormant for a very long time. During the dormant years, the patient was clinically healthy. To our knowledge a recurrent infection with this microorganism has not previously been reported in the literature. Images

Freidin, N; Merzbach, D; Kleinhaus, U; Eidelman, S



Postappendectomy intra-abdominal abscess: a therapeutic approach.  

PubMed Central

Four hundred and sixty two children were operated on between January 1989 and June 1993 for acute appendicitis; 10 developed an intra-abdominal abscess. Intra-abdominal abscesses were accompanied by fever above 38 degrees C (nine out of 10 patients) and leucocytosis (mean leucocyte count 20.3 x 10(9)/l) and were detected sonographically four to 14 days after operation. Management included intravenous administration of antibiotics effective against both aerobes and anaerobes, and follow up with serial sonographic studies. Eight patients responded favourably to antibiotic treatment without any drainage procedure, with gradual shrinkage and collapse of abscesses. Two patients, in whom enlargement of collection was demonstrated on serial sonographic examination, eventually underwent percutaneous drainage under sonographic control. These results suggest that some paediatric patients with an intra-abdominal abscess after appendicectomy and who are followed up closely by sonography may be managed successfully with appropriate antibiotics alone. Images

Gorenstein, A; Gewurtz, G; Serour, F; Somekh, E



Fish bone migration: an unusual cause of liver abscess.  


Treating a pyogenic liver abscess is a therapeutic challenge when a patient presents with atypical symptoms. One of the rare causes of treatment failure of these abscesses is the unrecognised migration of a foreign body from the gastrointestinal tract. The authors describe a pyogenic liver abscess in a 45-year-old male who presented with a 10 day history of fever, and abdominal pain. A CT scan of the abdomen revealed a needle-like foreign body in the liver. At operation a 2.5 cm fish bone was extracted from the liver. Subsequently, his feverish symptoms disappeared, and he has remained well in the ensuing 3 month postoperative period. Fish bone-induced liver abscess is discussed in this brief report. PMID:22605588

Masoodi, Ibrahim; Alsayari, Khalid; Al Mohaimeed, Khalid; Ahmad, Shameem; Almtawa, Abdulla; Alomair, Ahmed; Alqutub, Adel; Khan, Salman



Fish bone-induced hepatic abscess: medical treatment.  


We report a case of a 59-year-old man admitted for acute myocardial infarction. He subsequently spiked a high-grade fever on the second day after percutaneous coronary intervention. Computed tomography imaging of the abdomen revealed a hepatic abscess secondary to gastrointestinal perforation by a fish bone. Medical therapy with antibiotics was preferred over surgical drainage of the hepatic abscess in view of the fact that the patient was on dual antiplatelet agents. The hepatic abscess was completely resolved with conservative antimicrobial therapy. Antimicrobial therapy appears to be a viable option in selected patients with hepatic abscess secondary to fish bone perforation, especially if they have contraindications to surgery. PMID:21451917

Ng, C T; Htoo, A; Tan, S Y



[A case of urachal abscess accompanied by a stone].  


A 64-year-old woman presented to our hospital with the chief complaints of abdominal pain and appetite loss, and she was admitted to the internal medicine department. Kidney, ureter and bladder X-ray revealed intrapelvic calcification near the bladder, and so, the patient consulted our department. Computed tomography and magnetic resonance imaging revealed an urachal abscess accompanied by a stone. Open surgery was performed under general anesthesia. The mass adhered tightly to the intestine and bladder. The urachal abscess ruptured during the operation, and pus leaked into the intraabdominal cavity. Partial cystectomy was performed to remove the mass completely. The stone existed in the urachal abscess, and its constituents were CaOxa (51%) and CaP (49%). The pathological diagnosis was urachal abscess without malignancy. PMID:23633634

Okumura, Akiou; Tsuritani, Shinji; Kiriyama, Masato; Arai, Kazunori; Takagawa, Kiyoshi; Fuse, Hideki



Masticator space abscess in a 47-day-old infant  

PubMed Central

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

Kim, Eunhee; Jeon, Ju Hee; Shim, Yoon Hee; Lee, Kyu-Seok; Kim, So Young



Neonatal submandibular sialadenitis progressing to submandibular gland abscess  

Microsoft Academic Search

Submandibular sialadenitis is exceptionally rare in neonates. We describe a case of submandibular sialadenitis progressing to submandibular abscess in a term neonate. The aetiology, investigations and treatment for this very rare condition are discussed.

Ron Bova; Paul Walker



A novel vaccine targeting Fusobacterium nucleatum against abscesses and halitosis  

PubMed Central

An abscess in a gum pocket, resulting from bacterial infection, is a common source of chronic halitosis. Although antibiotics are generally prescribed for abscesses, they require multiple treatments with risks of creating resistant bacterial strains. Here we develop a novel vaccine using ultraviolet-inactivated Fusobacterium nucleatum (F. nucleatum), a representative oral bacterium for halitosis. A gum pocket model, established by continuous inoculation of F. nucleatum, was employed to validate the vaccine potency. Mice immunized with inactivated F. nucleatum effectively minimized the progression of abscesses, measured by swollen tissues of gum pockets. Most notably, the immunized mice were capable of eliciting neutralizing antibodies against the production of volatile sulfur compounds of F. nucleatum. The novel vaccine inducing protective immunity provides an alternative option to conventional antibiotic treatments for chronic halitosis associated with abscesses.

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



Fatal case of retropharyngeal abscess associated with Pott's disease.  


Retropharyngeal abscess is a rare, deep seated infection of the neck that usually affects young children. Chronic retropharyngeal abscess is rare and results from tuberculosis of the spine. Such swelling in the neck gradually increases in size and is detected during the routine radiological screening for symptoms like pain, dysphagia, fever, dyspnoea, progressive inspiratory stridor (from laryngeal obstruction), neck hyperextension etc, but rarely leads to sudden death due to airway obstruction. Thus the forensic pathologist rarely comes across such type of cases. Present case concerns obstruction of upper airway by a large retropharyngeal cold abscess leading to death in a 13-year-old female child from a lower socio-economic family. The possible explanation for the progression and fatal outcome of such abscesses associated with the Pott's disease is being discussed in the light of available literature. PMID:23910833

Hugar, Basappa S; Chandra, Y P Girish; Babu, P R Sreenivasa; Jayanth, S H; Vinay, J



Bacterial and viral parenchymal infections of the brain.  


Magnetic resonance imaging (MRI) has been proven to aid in the early detection and diagnosis of parenchymal infections of the brain. Pyogenic brain abscess, herpes encephalitis, Listeria rhombencephalitis, and Rasmussen's syndrome are examined in this article. Imaging characteristics, epidemiology, clinical presentations, therapies, and pathologic findings are discussed. PMID:8311953

Buff, B L; Mathews, V P; Elster, A D



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

SciTech Connect

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.

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



Hepatic abscess: Sensitivity of imaging tests and clinical findings  

Microsoft Academic Search

The imaging studies of 63 patients with hepatic abscess were evaluated to determine the sensitivity of specific imaging tests and define causes of false-negative test results. Computed tomography (CT) detected 57 of 59 (97%) separate episodes of hepatic abscess. The two false-negative CT examinations were in patients with a diffuse low-density pattern throughout the liver. The radionuclide (RN) examination detected

Robert A. Halvorsen; William L. Foster; Robert H. Wilkinson; Paul M. Silverman; William M. Thompson



Cutaneous gonococcal abscess of the abdomen in a child.  


Virtually all pediatric cases of Neisseria gonorrhoeae originate from contact with an infected adult. A cutaneous abscess caused by N. gonorrhoeae in a child is extremely rare, especially outside the genital area. We report a case of a 22-month-old boy with a gonococcal cutaneous abscess on the abdominal wall and suggest that N. gonorrhoeae should be included in the differential diagnosis of skin and soft tissue infections in children. PMID:21926887

Dickson, Scott D; Alter, Sherman J



Treatment of Acute Puerperal Mastitis and Breast Abscess  

PubMed Central

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.

Cantlie, Helene Bertrand



Pyogenic hepatic abscess after pancreatic resection for chronic pancreatitis.  

PubMed Central

Seventeen patients underwent surgery for alcohol-induced chronic pancreatitis. Three patients later presented with pyogenic liver abscess. The time interval between surgery and presentation with hepatic abscess varied from 6 weeks to 3.5 years. All patients were diabetic, the presentation was insidious and all made an uneventful recovery, two with percutaneous drainage and one with antibiotics alone. The aetiology of this uncommon complication is discussed.

Ravichandran, D.; Carty, N. J.; Johnson, C. D.



Human toxocariasis and pyogenic liver abscess: a possible association  

Microsoft Academic Search

OBJECTIVES:To study the role of human toxocariasis in the pathogenesis of pyogenic liver abscess.METHODS:We compared the serology for toxocariasis and serum levels of IgE in 16 patients with pyogenic liver abscess to those in 32 matched (age and gender) controls to define the possible association between these two entities.RESULTS:The serology for toxocariasis was positive in 10 of 16 patients compared

Abdunnabi A. Rayes; Daniela Teixeira; J. C. Serufo; Vandack Nobre; Carlos M. Antunes; J. R. Lambertucci



Paraspinal abscess complicated by endocarditis following a facet joint injection.  


Infectious complications secondary to lumbar facet injections are exceedingly rare, follow an indolent course, and local sequelae include abscess spread or infections of the central nervous system. We present the case of the development of a facet abscess and infective endocarditis, which developed shortly after a lumbar facet injection. With the increase in interventional pain procedures, physicians must be aware of potential infectious complications. PMID:17606390

Hoelzer, Bryan C; Weingarten, Toby N; Hooten, W Michael; Wright, R Scott; Wilson, Walter R; Wilson, Peter R



Different actions of deferoxamine and iron on Ga-67 abscess detection in rats  

SciTech Connect

The contrast-enhancing properties of iron (Fe) and deferoxamine (DFO) in abscess imaging with Ga-67 citrate were compared in rats bearing turpentine-induced abscesses. Iron administration shifted Ga-67 from plasma into tissues such as muscle and fat. As a result, the abscess-to-plasma ratio increased whereas the abscess-to-muscle ratio decreased. DFO enhanced the abscess-to-muscle and abscess-to-plasma ratios by increasing urinary Ga-67 excretion. The authors conclude that abscess imaging with Ga-67 citrate may be improved by administration of (a) Fe for detection of abscesses masked by blood activity, or (b) DFO for detection of abscesses surrounded by muscle tissue.

Oberhensli, R.D.; Mueller, R.M.; Fridrich, R.



[Surgery of acute aortic valve endocarditis: prognosis in paravalvular abscess].  


The occurrence of paravalvular abscesses in the course of an acute endocarditis of the aortic valve indicates an advanced stadium of the disease. The infection has spread beyond the limits of the valve leaflets, and ongoing destruction of the paravalvular tissue is to be expected, if the endocarditis is continually treated by antibiotics alone. Surgery of acute endocarditis with paravalvular abscess, however, supposedly carries an increased risk of early mortality and late morbidity. The following prospective study was carried out to determine whether a radical surgical approach together with aggressive postoperative antibiotic therapy could help to improve results. Between 1988 and 1995, 138 patients were operated during the acute phase of infective endocarditis; in 102 the aortic valve was involved. Among these, 44 had paravalvular abscesses at the time of surgery. The mean age of both groups was the same, but there was a higher rate of concomitant coronary artery disease, multiple valve involvement, advanced NYHA-class, and staphylococcal disease among the patients with abscesses. All interventions were carried out with cardiopulmonary bypass and cardioplegic arrest. The aortic valve was resected, abscesses were removed, and each part of potentially infected or necrotic tissue was resected as complete as possible, irrespective of the possibility to jeopardize the conduction system or to create large tissue defects. The aortic valve was replaced with a mechanical prosthesis in each case. The postoperative antibiotic regimen was specifically directed against the microorganisms isolated preoperatively; therapy was only modified, if signs of systemic infection did not disappear three days after surgery. The operative mortality was 10% among patients without an abscess and 11% in patients with a paravalvular abscess. Early recurrent endocarditis was recorded in two patients without and in only one patient with an abscess. Late recurrent endocarditis was noted in three patients; none of them had abscesses at the time of surgery. We conclude that the operative risk of acute endocarditis of the aortic valve with a paravalvular abscess does not have to be inevitably higher compared to cases without paravalvular involvement. To achieve these results, it is necessary to use a radical surgical approach and to adjust postoperative antibiotic therapy, if infectious signs do not disappear shortly after surgery. PMID:9610511

Bauernschmitt, R; DeSimone, R; Lange, R; Vahl, C F; Thomas, G; Hagl, S



Pituitary abscess: a report of two cases.  


Pituitary abscess (PA) is an infrequent disease, which consists of an infection within the sella turcica that might be life-threatening. We present here two cases of this rare entity. Case 1: A 53-year-old woman was followed for an incidentally found pituitary cyst. Six years later the cyst enlarged and transsphenoidal surgery was performed. Two years later, the patient developed sudden onset of intense headache and nausea. The MRI showed a 2 by 2.5 cm sellar and suprasellar mass, that enhanced peripherally with gadolinium contrast and became hyperintense in T2-weighted images, suggesting a new-onset cystic lesion. During transsphenoidal surgery, large amounts of purulent material were drained from the sella. The cultures were positive for Klebsiella Ozaenae. Case 2: A 63-year-old woman, 4 years after transsphenoidal resection of a GH-secreting macroadenoma, developed a new sellar 2.6 cm cystic mass. On re-operation, purulent material was drained from the sella. The lesion persisted on the MRI and visual acuity worsened so a repeat pituitary decompression was carried out 6 months later, obtaining the same pathological results. Three years later, the MRI still shows the same mass. She feels well and her physical examination and clinical history are unremarkable. These cases illustrate the difficulties in the diagnosis and management of this rare entity. PMID:17458703

Danilowicz, Karina; Sanz, Carlos Francisco; Manavela, Marcos; Gomez, Reynaldo Manuel; Bruno, Oscar Domingo



Retropharyngeal Calcific Tendonitis Mimics a Retropharyngeal Abscess  

PubMed Central

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

Wexler, Sonya



Occurrence of silk stitch abscess after surgery in patients with oral squamous cell carcinoma  

PubMed Central

Objectives: To elucidate the predisposing factors and clinical characteristics related to the occurrence of stitch abscess after surgery in patients with oral squamous cell carcinoma (SCC). Patients and Methods: The subjects were 232 patients who underwent excision and/or reconstruction and/or neck dissection for oral SCC using silk sutures for high ligation of the blood vessels. Detection rates and characteristics of patients with stitch abscess were retrospectively evaluated by comparing patients with and without stitch abscesses after surgery diagnosed by ultrasonography and findings of various modalities in 232 patients. Several echogenic dots with subtle acoustic shadows in a hypoechoic mass were identified as the characteristic findings of stitch abscess on US. The patient groups with and without stitch abscess were compared with respect to various factors to identify those that predispose to the occurrence of stitch abscess. The factors analyzed included patients’ sex and age, chemotherapy treatment, radiotherapy treatment, the presence of a history of allergy, and blood test results. Results: A significant correlation was found between the occurrence of stitch abscess and age, liver function abnormalities on blood tests, and the presence of a history of allergy. Multiple stitch abscesses clearly tended to occur more often than single ones in patients with stitch abscess. Conclusions: The occurrence of stitch abscesses was related to age, liver dysfunction, and/or the presence of allergies. When diagnosing stitch abscess, the occurrence of multiple stitch abscesses is important. Key words:Stitch abscess, oral cancer, predisposition, characteristics, squamous cell carcinoma.

Yamamoto, Noriaki; Yamashita, Yoshihiro; Yoshiga, Daigo; Ishikawa, Ayataka; Matsuo, Kou; Miyamoto, Ikuya; Oda, Masafumi; Tanaka, Tatsurou; Kito, Shinji; Seta, Yuji; Takahashi, Tetsu; Koga, Hirofumi; Kawano, Kenji



Rapidly progressing subperiosteal orbital abscess: an unexpected complication of a group-A streptococcal pharyngitis in a healthy young patient  

PubMed Central

Introduction Complications associated to group-A streptococcal pharyingitis include non-suppurative complications such as acute rheumatic fever and glomerulonephritis and suppurative complications such as peritonsillar or retropharyngeal abscess, sinusitis, mastoiditis, otitis media, meningitis, brain abscess, or thrombosis of the intracranial venous sinuses. Case presentation We described a case of a 15-year-old patient with a history of acute pharyngodinia early followed by improvise fever and a progressive formation of a diffuse orbital edema, corneal hyperaemia, diplopia and severe decrease of visual acuity. The patient was surgically treated with functional endoscopic sinus surgery (FESS) after the response of a maxillofacial computed tomography scans that showed a pansinusitis complicated by a left orbital cellulites. Numerous colonies of Streptococcus pyogenes were found in the samples of pus and an antibiotic therapy with meropenem was initiated on the basis of the sensitivity test to antibiotics. The patient was finally discharged with diagnosis of left orbital cellulites with periorbital abscess, endophtalmitis and acute pansinusitis as a consequence of streptococcal pharyngitis. Conclusion The case highlights the possible unusual complication of a group-A streptococcal pharyingitis in a immunocompetent child and the needing of a prompt surgical and medical approach toward the maxillofacial complications associated to the infection.



Anterior left subphrenic abscess: characteristic plain film and CT appearance  

SciTech Connect

Abdominal abscesses located in the left upper quadrant may occur in two major anatomic locations, the subphrenic space or the lesser sac. The left coronary or triangular ligament extending from the dorsal aspect of the liver to the diaphragm separates the subphrenic space from the lesser sac. As the ligament usually extends posteriorly, the anterior subphrenic space extends under the dome of the diaphragm, occupying the most superior part of the left upper quadrant. Both the lesser sac and the left anterior subphrenic space extend to the right of midline. The left anterior subphrenic compartment is bounded on the right by the calciform ligament while the lesser sac extends to the right coronary ligament and foramen of Winslow. Therefore, abscesses either in the left anterior subphrenic compartment or lesser sac may extend across the midline into the right upper quadrant. Left anterior subphrenic abscesses will be immediately subdiaphragmatic while lesser sac abscesses extending to the right of midline will not usually extend up to the diaphragm. Six cases are presented demonstrating midline air-fluid levels and soft-tissue masses in the immediate subdiaphragmatic area, characteristic signs of anterior left subphrenic abscesses.

Halvorsen, R.A. (Duke Univ. Medical Center, Durham, NC); Jones, M.A.; Rice, R.P.; Thompson, W.M.



Spontaneous drainage of paravalvular abscess diagnosed by transesophageal echocardiography.  


Paravalvular abscesses, which occur in up to 30% of cases of native valve endocarditis, are being detected with increasing frequency with the use of transesophageal echocardiography. Abscesses of the mitral aortic intervalvular fibrosa have been described but only in association with native or prosthetic aortic valve endocarditis. We describe a patient with native mitral valve endocarditis complicated by an abscess in the fibrosa. A 51-year-old diabetic man presented with Staphylococcus aureus mitral valve endocarditis. A transesophageal echocardiographic study done 8 days after admission revealed two large masses at the base of the anterior mitral leaflet with extension into the fibrosa consistent with a paravalvular abscess that was not detected by precordial echocardiography. A repeat transesophageal echocardiographic study done 20 days after admission showed spontaneous drainage of the abscess and a subsequent fistula between the left atrium and left ventricle. This case highlights the important role that transesophageal echocardiography has in suspected and known cases of endocarditis. Its major advantage of delineating posterior cardiac structures allowed accurate diagnosis and serial evaluation of this previously unreported complication of endocarditis. PMID:1910838

Giannoccaro, P; Ascah, K J; Sochowski, R A; Chan, K L; Ruddy, T D


A quantitative model for subcutaneous abscess formation in mice.  

PubMed Central

The purpose of this experiment was to develop an experimental model of s.c. encapsulated abscesses in which abscess formation could be assessed by quantitative measurements. Inocula were composed of bacterial broth cultures, autoclaved mouse caecal contents or both in combination. These inocula were injected s.c. on the flank in 2 strains of mice. Large encapsulated abscesses formed in all recipients by Day 4 when the inoculum contained either B. fragilis or S. aureus combined with caecal contents. Bacterial concentrations per ml of pus at Day 6 were 10(10.1+/-0.02) for B. fragilis and 10(8.4+/-0.1) for S. aureus. Spontaneous external drainage began by 10--15 days, and complete healing of the lesion occurred by 4--6 weeks. The typical histological pattern consisted of a collagen capsule surrounding a rim of neutrophils, enclosing a central area of necrotic cells and fibre from the inoculum. The cross-sectional areas of the capsule, the neutrophil band and the entire abscess were measured in a reproducible manner by planimetry, and abscess volumes were calculated. Values for these measurements varied with different inocula and different times after inoculation, but were highly consistent for a specified time and inoculum. Images Fig. 1 Fig. 2 Fig. 3

Joiner, K. A.; Onderdonk, A. B.; Gelfand, J. A.; Bartlett, J. G.; Gorbach, S. L.



Epidural abscess caused by Streptococcus milleri in a pregnant woman  

PubMed Central

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

Lampen, Russell; Bearman, Gonzalo



Transient interference with staphylococcal quorum sensing blocks abscess formation  

PubMed Central

The staphylococcal virulon is controlled largely by the agr locus, a global accessory gene regulator that is autoinduced by a self-coded peptide (AIP) and is therefore a quorum sensor. The agr locus has diverged within and between species, giving rise to AIP variants that inhibit heterologous agr activation, an effect with therapeutic potential against Staphylococcus aureus: a single dose of an inhibitory AIP blocks the formation of an experimental murine abscess. As the AIP is unstable at physiological pH, owing to its essential thiolactone bond, its single-dose efficacy seems paradoxical, which has led us to analyze the in vivo kinetics of agr activation and the consequences of its blockage by a heterologous AIP. Initially, the infecting bacteria grow rapidly, achieving sufficient population density within the first 3 h to activate agr, and then enter a neutrophil-induced metabolic eclipse lasting for 2–3 d, followed by agr reactivation concomitantly with the development of the abscess. The inhibitory AIP prevents agr expression only during its short in vivo lifetime, suggesting that the agr-induced and therefore quorum-dependent synthesis of virulence factors shortly after infection is necessary for the subsequent development of the abscess lesion and bacterial survival. We confirm this finding by showing that a sterile agr+ supernatant causes a sterile abscess similar to the septic abscess caused by live bacteria. These results may provide a biological rationale for regulation of virulence factor expression by quorum sensing rather than by response to specific host signals.

Wright, Jesse S.; Jin, Rhuzong; Novick, Richard P.



Hepatic Abscess Complicating Transarterial Chemoembolization in a Patient with Liver Metastases  

PubMed Central

Hepatic abscess following transarterial chemoembolization is an uncommon complication. The authors describe a case of liver abscess after transarterial chemoembolization for neuroendocrine liver metastases, including risk factors, prophylaxis, treatment, and outcomes.

Johnson, Guy E.; Ingraham, Christopher R.; Nair, Ajit V.; Padia, Siddharth A.



Aspergilloma of the brain: an overview Aspergilloma of the brain: an overview Aspergilloma of the brain: an overview Aspergilloma of the brain: an overview Aspergilloma of the brain: an overview  

Microsoft Academic Search

ABSTRACT ABSTRACT ABSTRACT ABSTRACT Fungal infections of the central nervous system (CNS) are almost always a clinical surprise. Their presentation is subtle, often without any diagnostic characteristics, and they are frequently mistaken for tuberculous meningitis, pyogenic abscess, or brain tumor. Granulocytopenia, cellular and humoral mediated immune dysfunction are predisposing factors to the development of CNS infections in immunosuppressed patients. Aspergillus

T. Nadkarni; A. Goel


Urachal cyst presenting with huge abscess formation in adults  

PubMed Central

Urachal disease, a disorder where embryonic remnant of the cloaca and the allantois present after birth as a midline fibrous cord, is usually detected in infancy and childhood. But urachal disease in adults is rare. We report a case of a huge abscess derived from a urachal cyst in an adult. A 52-year-old man presented with peri-umbilical distension and abdominal pain for 2 weeks. Ultrasonography and abdominal computed tomography scan demonstrated a huge abscess derived from the abdominal wall. After prompt incision and drainage, the remaining abscess cavity was removed completely under general anesthesia. Pathologic report was consistent with urachal duct cyst, and the patient was discharged in a week without complication.

Lee, Sung Hwan; Lee, Hyang Im



Management of Pleural Effusion, Empyema, and Lung Abscess  

PubMed Central

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.

Yu, Hyeon



Obturator internus muscle abscess in a child: a case report.  


The authors report a case of abscess in the obturator internus muscle, which is a rare occurrence. It was managed with antibiotics and surgical intervention was not necessary. Pyomyositis involving the muscles around the hip needs to be differentiated from septic arthritis and transient synovitis of the hip because these pathologies more commonly afflict this joint. However, when present, abscesses usually affect the psoas or the glutei. Only rarely is the obturator internus involved by the abscess. Magnetic resonance imaging is the imaging modality of choice to image the obturator internus and to ascertain the diagnosis. Lack of awareness of the existence of this condition leads to a delay in the correct diagnosis. PMID:19471173

Bansal, Manish; Bhaliak, Vijay; Bruce, Colin E



[Abscess-forming retroperitoneal actinomycosis after urogynaecological surgery].  


Human actinomycosis is an infrequent chronic infection caused by gram-positive anaerobic bacteria with predominantly cervicofacial and intestinal manifestation. Retroperitoneal abscess formation displays a very rare localisation and is mostly incidentally diagnosed by histological examination. We report on a 44-year-old woman with left-sided flank pain and retroperitoneal abscess formation diagnosed by CT scan. Case history revealed preceding nephroureterectomy of the left kidney due to loss of kidney function and recurrent ureteral-vaginal fistulas. After CT scan-guided puncture and negative bacterial culture, actinomycosis could only be diagnosed by histopathological examination. Subsequently, besides abscess drainage calculated antibiotic therapeutic regimen was initiated. During the follow-up of 9 months there was no local or systemic recurrence. In the present case report, aetiology, clinical symptoms as well as diagnostic and therapeutic consequences are discussed. PMID:20628866

Rud, O; May, M; Brookman-May, S; Mörsler, J; Rotter, M; Gilfrich, C



[Peritonsillar abscess - smoking habits, preoperative coagulation screening and therapy].  


Peritonsillar abscess (PTA) is a common problem in otorhinolaryngology. The pathogenesis, supporting factors and optimal therapy are matter of numerous investigations. We studied retrospectively smoking habits, preoperative coagulation screening and the applied therapy of PTA.Data from 460 patients who underwent treatment for PTA between 2000 and 2009 at Dessau Medical Center were retrospectively analysed.The highest incidence of PTA was found in young men, the prevalence of nicotine consumption was clearly increased in relation to the general population. The therapy of first choice was abscess tonsillectomy. Even with preoperative pathological coagulation-parameters no increased risk of secondary bleeding was shown.The part of smokers of patients with PTA is increased in comparison to the correspondent population of same age. A routine preoperative coagulation screening has a low benefit relating to the prediction of the risk of secondary bleeding. Abscess tonsillectomy is a safe method and has proved itself in clinical daily routine. PMID:23996551

Uhler, M; Schrom, T; Knipping, S



Isolated tubercular liver abscess in an elderly diabetic successfully treated with systemic antitubercular drugs.  


Tubercular liver abscess is a rare extrapulmonary manifestation of tuberculosis. We are presenting a case of isolated tubercular liver abscess in a 70 year old diabetic male without any evidence of tuberculosis in the lungs or abdomen. Diagnosis was made on the basis of radiological findings along with PCR for Mycobacterium tuberculosis in pus aspirated from abscess under CT guidance. Systemic antitubercular drugs were given for 6 months. On follow up patient improved clinically with radiological evidence of resolution of abscess. PMID:22755384

Rai, Rahul; Tripathi, Vishwa Deepak; Rangare, Vikas; Reddy, D Sunil; Patel, Pushpraj



Is "primary" subphrenic abscess caused by Streptococcus milleri a result of unrecognized gastrointestinal perforation?  


An unusual case of subphrenic abscess presenting as empyema of the pleural cavity is described. The abscess developed secondarily to an occult perforation of the gastrointestinal tract, which was, diagnosed indirectly by the discovery of a fishbone within the abscess. Isolation of Streptococcus milleri from the pus was an important clue for the existence of an underlying gastrointestinal pathology. PMID:3520131

Admon, D; Gottehrer, N; Leitersdorf, E



Identification of a Major Cluster of Klebsiella pneumoniae Isolates from Patients with Liver Abscess in Taiwan  

Microsoft Academic Search

Klebsiella pneumoniae has emerged as the leading liver abscess pathogen in Taiwan, with the percentage rising from 30% in the 1980s to over 80% in the 1990s. Most of the patients with K. pneumoniae liver abscess are diabetic and without biliary tract disease. Some patients develop serious extrahepatic complications such as endophthalmitis, meningitis, lung abscess, and necrotizing fasciitis. Pulsed-field gel




Microbiology and Management of Pediatric Liver Abscesses: Two Cases Caused by Streptococcus anginosus Group  

PubMed Central

Pyogenic liver abscesses in the pediatric population are rare occurrences in the developed world. We present two cases of previously healthy males presenting with fever and abdominal pain found to have liver abscesses due to organisms in the Streptococcus anginosus group. The microbiology of S. anginosus along with the management and recommended treatment in children with liver abscesses is discussed.

Cellucci, Michael; Simon, Erin; Eppes, Stephen



Metastatic myocardial abscess on the posterior wall of the left ventricle: a case report  

Microsoft Academic Search

INTRODUCTION: Myocardial abscess is a rare and potentially fatal condition. Metastatic myocardial abscess in the setting of infective endocarditis has been infrequently reported in the medical literature. To the best of the authors' knowledge no case of myocardial abscess affecting the free wall of the left ventricle secondary to infective endocarditis of a right-sided heart valve has been reported previously.

Javaid Iqbal; Iftikhar Ahmed; Wazir Baig



Retroperitoneal abscess following infected bipolar hemiarthroplasty diagnosed by metallosis: a case report.  


We present a patient with the rare association of a retroperitoneal abscess and infected bipolar hemiarthroplasty diagnosed by metallosis in the abscess preoperatively. T1 and T2 weighted magnetic resonance images revealed a very low signal area, suggesting the presence of particulate metal in the abscess. Critical interpretation of imaging may be useful in such cases. PMID:20640995

Fujishiro, Takaaki; Hayashi, Shinya; Kanzaki, Noriyuki; Oka, Shinya; Kurosaka, Masahiro; Nishiyama, Takayuki


[Puncture drainage of abscess of the liver and abdominal cavity controlled by echotomoscopy and laparoscopy].  


In 13 patients, the diagnosis of abscesses and subsequent puncture treatment were performed under echotomoscopic guidance, in 4--simultaneous laparoscopy was used. In 2 patients, the puncture method of treatment has proved to be ineffective, and they required the abscess opening. One female patient died from abscessed primary hepatic cancer. PMID:2140140

Krivitski?, D I; Palamarchuk, V I



Bartholin's abscess complicating food poisoning with Salmonella panama: a case report.  

PubMed Central

A patient is presented who developed an acute Bartholin's abscess four weeks after an attack of Salmonella panama enteritis. Aspirate from the abscess also grew Salmonella panama, indistinguishable from the gut isolate in serotype and antigenic structure (1 9, 12: 1, v: 1,5). Some aspects of the microbiology of Bartholin's abscess and its clinical management are discussed.

Cummins, A J; Atia, W A



Spinal epidural abscess due to Staphylococcus aureus: clinical manifestations and outcomes  

Microsoft Academic Search

Background and Purpose: Despite advances in diagnosis and treatment, spinal epidural abscess due to Staphylococcus aureus remains a challenge to clinicians. In this study, we describe the clinical features and outcomes of patients with spinal epidural abscess due to S. aureus. Methods: Thirty one cases of spinal epidural abscess due to S. aureus treated at the National Taiwan University Hospital

Wan-Chin Chen; Jiun-Ling Wang; Jann-Tay Wang; Yee-Chun Chen; Shan-Chwen Chang



Staphylococcus aureus abscess of the spleen in a beta-thalassemia patient.  


Splenic abscesses are rare among abdominal abscesses. We present a case of splenic abscess due to Staphylococcus aureus in a beta-thalassemia major patient. Such a complication may not be coincidental, as beta-thalassemia major patients have an increased susceptibility to infection, which is attributable to a number of immune abnormalities. PMID:12160176

Aessopos, Athanasios; Politou, Marianna; Farmakis, Dimitrios; Sideris, Panagiotis; Grapsa, Anneta; Andreopoulos, Anastasios; Kalahanis, Nikolaos; Karagiorga, Markisia



Seminal vesicle abscess following prostate biopsy requiring transgluteal percutaneous drainage.  


Transrectal ultrasound guided biopsy (TRUSB) of the prostate directly contaminates the prostate with rectal flora. Patients commonly receive fluoroquinolone (FQ) antibiotics to prevent infection. Infectious complications following TRUSB are increasing. The most common offending organism is Escherichia coli (E. coli), with isolates of this bacteria showing growing resistance to FQs. We present to our knowledge the first reported case of seminal vesicle abscess formation after TRUSB. The abscess was initially not seen on computed tomography and eventually treated with percutaneous drainage by a transgluteal approach. We review literature on infectious complications following TRUSB with implications for future antibiotic prophylaxis. PMID:23783054

Bayne, Christopher E; Davis, William A; Rothstein, Christopher P; Engel, Jason D



Scrotal Abscess as Initial Presentation of Squamous Cell Carcinoma  

PubMed Central

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.

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



[Mediastinal abscess caused by self-mutilation of the hypopharynx].  


A 44-year-old male with a non-specific psychological disturbance was diagnosed with septicemia. The patient had unsuccessfully tried to remove what he believed to be a fish bone from his throat. Computed tomography revealed a descending abscess in the mediastinum along with perforations in the pharynx and oesophagus to the mediastinum. He was treated with antibiotics and drainage of the abscess and discharged after six weeks without sequelae. Sharp foreign bodies in the pharynx should be removed professionally to avoid perforation and thus mediastinitis. PMID:20525475

Bak, Nikolaj Bolsing; Rasmussen, Niels



Primary pituitary abscess with coexisting pyogenic meningitis: an unexpected diagnosis.  


Primary pituitary abscess is a very rare disease most likely associated with pyogenic infection. A 27-year-old woman was initially diagnosed and treated as a case of acute pyogenic meningitis. In view of persistent headache, impaired visual fields, galactorrhea and menstrual irregularities, she underwent evaluation of pituitary mass lesion. Magnetic resonance imaging of the pituitary reported the mass as pituitary macroadenoma. However, transsphenoidal surgery revealed copious collection of purulent materials confirmed as pyogenic pituitary abscess. A follow-up magnetic resonance imaging of the pituitary 2 years later confirmed secondary empty sella. She has developed panhypopituitarism; she remains on appropriate anterior pituitary hormone replacement. PMID:23262813

Bangera, Sachin; Chattopadhyay; Singh, Ranjit Kumar; Al Asousi, Adnan Ali; Joseph, Elizabeth



Aortic root abscess resulting from endocarditis: spectrum of angiographic findings  

SciTech Connect

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.

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



[Prosthetic valve endocarditis associated with paravalvular aortic and mitral abscesses].  


A 63-year-old female, who had undergone aortic and mitral valve replacement 16 years ago, was admitted because of urinary tract infection. The patient developed cerebral hemorrhage. Methicillinresistant Staphylococcus aureus was isolated from her blood culture. Transesophageal echocardiography revealed paravalvular aortic and mitral abscesses, and the diagnosis of prosthetic valve endocarditis was established. A redo double valve replacement was performed. Both paravalvular abscess cavities were debrided and closed with fresh autologous pericardial patches, and mechanical valves were implanted. The patient's postoperative course was uneventful, and she had no sign of recurrent infection 3 years postoperatively. PMID:22374598

Aoki, Takayuki; Nishizawa, Junichiro; Nishio, Hiroomi



Pretracheal Abscess Following Two Weeks of Endotracheal Intubation  

PubMed Central

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.

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



Obturator internus pyomyositis presenting as a pararectal abscess  

PubMed Central

This report describes two children who presented with fever, hip pain and a limp, and were subsequently found to have a primary pyomyositis of the obturator internus muscle. A clinical diagnosis of septic arthritis of the hip was made initially, but in both children MRI showed a pararectal abscess, which required incision and drainage. Staphylococcus aureus was cultured from pus from the abscesses and both children made a full recovery subsequently. This report highlights the main features of this unusual entity and emphasises the need for early imaging in the child with an unexplained limp.

Duthie, Gillian; Corry, Caroline; Munro, Fraser; Robb, James



Internal obturator muscle abscess caused by Klebsiella pneumoniae.  


Obturator internus muscle abscess is an infrequent form of pyomyositis. To date, this disease has been described almost exclusively in children and young adults, and in most cases the causative agents are Gram-positive bacteria. We present the first report of obturator internus muscle abscess caused by a highly antibiotic resistant Klebsiella pneumoniae, in an elderly diabetic patient. Once considered very rare, Gram-negative pyomyositis is increasingly reported, and is an important concern in diabetic patients. Since pyomyositis can easily be missed if not considered, physicians should become familiar with this condition, and consider it in the differential diagnosis of septic diabetic patients. PMID:17055584

Yahalom, G; Guranda, L; Meltzer, E



Multiple Liver Abscess Formation and Primary Gastrointestinal Stromal Tumor  

PubMed Central

Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. The introduction of a number of small molecule tyrosine kinase inhibitors has revolutionized the management of metastatic disease. Surgery is the mainstay of management for localized disease. Patients with high risk tumors are treated with adjuvant imatinib. We report the rare presentation of a localized primary small bowel gastrointestinal stromal tumor in association with multiple liver abscesses. Cystic liver lesions should be fully evaluated in gastro intestinal tumor patients to exclude an infective cause. Treatment with intravenous antibiotics resulted in clinical and radiological improvement of the liver abscesses. The small bowel tumor was treated with surgical resection.

E. Chang, Amy; N. Mann, Gary; Hoch, Benjamin; T. Loggers, Elizabeth; M. Pollack, Seth; Kolokythas, Orpheus; L. Jones, Robin



Iliopsoas abscess: a report of 24 patients diagnosed by CT  

Microsoft Academic Search

Background: We wanted to define the role of computed tomography (CT) in the diagnosis, etiology, and treatment of iliopsoas abscess.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: Twenty-four patients (18 men, six women; age range = 17–86 years) with iliopsoas abscesses diagnosed over 8 years were retrospectively\\u000a reviewed. All presented with fever and elevated white blood cell counts. Twenty-one had abdominal, flank or pelvic pain and

R. Zissin; G. Gayer; E. Kots; M. Werner; M. Shapiro-Feinberg; M. Hertz



Effect of a Single Percutaneous Abscess Drainage Puncture and Imipenem Therapy, Alone or in Combination, in Treatment of Mixed-Infection Abscesses in Mice  

Microsoft Academic Search

The importance of supplementary imipenem therapy after a single percutaneous abscess drainage puncture was studied in a mouse model of established mixed-infection abscesses. Animals were treated for 3 days with daily dosing regimens of 384 to 1,536 mg\\/kg of body weight that took into account the short half-life of this antibiotic in mice. Imipenem therapy in conjunction with abscess drainage

Lorna E. T. Stearne; Steven L. Buijk; Johan W. Mouton; Inge C. Gyssens



Gonococcal scalp abscess in a neonate delivered by caesarean section  

PubMed Central

Gonococcal infection in caesarean delivered babies is very rare and is usually limited to ophthalmia neonatorum. The mother had rupture of membranes 14 hours before the caesarean section. The infection was most likely introduced by the fetal scalp electrode probes applied 2 hours before delivery. This is the first reported of a neonatal gonococcal abscess in a caesarean delivered infant. ?????

Varady, E.; Nsanze, H.; Slattery, T.



Streptococcus milleri head and neck abscesses: a case series.  


Streptococcus milleri infections and abscesses in the head and neck region have been previously reported, but there is still a dearth of clinical literature on this topic. To add to the available reports and to promote a better understanding and awareness of this clinically important entity, we present this retrospective review of 7 cases of head and neck abscess caused by S milleri infection. We have placed particular emphasis on antibiotic sensitivity patterns. These patients-6 men and 1 woman, aged 28 to 73 years (mean: 42.7)-had been seen at a district general hospital in Gosford, Australia, over a 6-month period. All patients had undergone surgical intervention and had been treated with intravenous antibiotics. All the S milleri cultures were sensitive to penicillin G, cephalexin, and erythromycin. Six of these patients experienced a resolution of their abscess, while 1 patient died from overwhelming sepsis. We believe that the initiation of penicillin G, cephalexin, or erythromycin is a good starting point for empiric therapy. S milleri should be considered as a causative organism in a patient who presents with a head and neck abscess, especially in the presence of a dental infection. Such a patient should be monitored closely for airway obstruction and distal infective sequelae. Also in this article, we compare our findings with those reported in two other published series. PMID:22711392

Foxton, Christopher Robert; Kapila, Smariti; Kong, Justin; Thomson, Neil John



Infratemporal and temporal fossa abscess complicating dental extraction.  

PubMed Central

Abscess formation in the infratemporal and temporal fossae is rare. Their presentation to accident and emergency departments is unusual and consequently may cause problems with diagnosis. Once diagnosed, treatment should be aggressive with intravenous antibiotics and surgical drainage. Images Figure 1 Figure 2

Diacono, M S; Wass, A R



[Symptomatic SUNCT with cerebral abscess and subdural empyema].  


SUNCT syndrome is a rare form of a primary headache disorder, although secondary causes, particularly posterior fossa abnormalities, are well known. We report a new case in a 67-year-old man suffering SUNCT syndrome secondary to pyogenic cerebral abscess and empyema localized in the convexity portion of the right frontal lobe. PMID:17878810

El Amrani, M; Roger, J-C; Fossati, P; De Monredon, J; Serveaux, J-P



Nocardial cerebral abscess cured with imipenem\\/amikacin and enucleation  

Microsoft Academic Search

A 72 year old female with cerebral abscess due to Nocardia farcinica is reported. Needle aspiration, antimicrobial therapy using a new combination of imipenem and amikacin, and, finally, surgical excision led to prompt and complete recovery. This is the oldest patient to survive cerebral nocardiosis reported in the literature. This infection, is usually regarded as opportunistic and is encountered with

Andreas Krone; Klaus P. Schaal; Alexander Brawanski; Bernard Schuknecht



Ischiorectal fossa abscess after pelvic floor injection of botulinum toxin.  


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

Brueseke, Taylor J; Lane, Felicia L



[Perivesical abscess secondary to ruptured appendicitis : a case report].  


A 38 year-old man was referred to our hospital for high fever and lower abdominal pain. The laboratory data showed his inflammatory state with a few puss cells in the urine analysis. Computed tomography (CT) scan and magnetic resonance imaging (MRI) scan demonstrated perivesical abscess and the cystoscopy on the day just before the operation revealed no abnormal findings in the bladder mucosa. In the operation, under the preoperative diagnosis of pyourachus, the appendix with the tip open was found inside the abscess cavity. Therefore, appendectomy and partial cystecomy were carried out. On the grounds of the pathological findings ; remarkable inflammatory change in the perivesical fatty tissue and slight inflammatory lesions in the subserous layer of the appendix, in addition to the clinical course and the retrospective findings of the preoperative MRI scan : existence of a tubular structure connecting with the abscess cavity, the final diagnosis was made as perivesical abscess secondary to ruptured appendicitis. This case is reported with a brief discussion as to the diagnosis and treatment. PMID:20372046

Kobayashi, Masataka; Osaka, Kimito; Fujikawa, Atsushi; Oouchi, Hideki; Iwasaki, Akira; Nagahori, Yutaka; Shiono, Yutaka



Tuboovarian Abscess Caused by Atopobium vaginae following Transvaginal Oocyte Recovery  

PubMed Central

A 39-year-old woman with tubarian sterility fell ill with acute pelvic inflammatory disease 2 months after transvaginal oocyte recovery. Laparotomy revealed a large tuboovarian abscess, from which Atopobium vaginae, an anaerobic gram-positive coccoid bacterium of hitherto unknown clinical significance, was isolated. The microbial etiology and the risk of pelvic infections following transvaginal punctures are discussed.

Geissdorfer, Walter; Bohmer, Christoph; Pelz, Klaus; Schoerner, Christoph; Frobenius, Wolfgang; Bogdan, Christian



Asymptomatic retropharyngeal abscess related to cervical Pott's disease  

Microsoft Academic Search

Pott's disease is an uncommon manifestation of tuberculosis, which usually involves thoracic or lumbar vertebrae. The body of the vertebrae is most severely affected and a compression fracture is an almost inevitable consequence of the disease. A paravertabral abscess generally accompanies vertebral involvement. Tenderness over the involved vertebrae, weakness of the related muscles, and paraesthesia are the usual symptoms. In

Fatih Öktem; M. Güven Güvenç; Süleyman Y?lmaz; D. Tuna Edizer; Batuhan Kara



Esophageal perforation with mediastinal abscess in child abuse  

Microsoft Academic Search

A case of mediastinitis and mediastinal abscess due to cervical esophageal perforation in a 9 1\\/2 month old girl who was a victim of child abuse and possible sexual assault is reported. Injury to the hypopharynx or esophagus with child abuse as a possible etiology should be considered when an infant or young child presents with unexplained erythematous neck swelling,

D. S. Ablin; M. A. Reinhart



Pyogenic Liver Abscess Following Acupuncture and Moxibustion Treatment  

PubMed Central

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.

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



Retinal abscess: case report of an uncommon evolution.  


We report a case of focal subretinal abscess in a 27-year-old diabetic man presenting with Staphylococcus sepsis. The follow-up study was based on visual acuity (VA), fundus photography, fluorescein angiography, ultrasound and optical coherence tomography, and an intravenous specific antibiotic was administered with an unusual good outcome. PMID:21769538

Trigui, A; Laabidi, H; Khairallah, M; Féki, J



Left ventricle to left atrium shunt via a paravalvular abscess.  


Intracardiac fistulas are rare complications of infective endocarditis that contribute to the complexity of surgical management, and impose an additional hemodynamic burden on the already challenged heart. We report on a case of successful surgical management of a paravalvular communication between the left ventricle and the left atrium via an abscess cavity. PMID:19795331

Gasparovic, H; Smalcelj, A; Brida, M



[Multiple hepatic abscesses due to actinomycosis: difficulties of diagnosis].  


Authors present the case of a 65 year-old man without any remarkable previous illness, hospitalized because of having prolonged fever caused probably by an infection due to a tick bite. Tularaemia and bartonellosis based on serological results as well as neoplasm of the sigma with multiple metastases to the liver raised by ultrasonography and abdominal CT could be excluded with detailed investigations. Multiple abscesses of the liver were diagnosed, followed by a percutaneuos ultrasonography directed aspiration of one of the abscesses which resulted in 150 ml buffy pus. Microbiological examination evaluated the presence of Actinomyces meyeri. Instead of neoplasm, diverticulosis and diverticulitis of the sigma could be clarified with perforation of one of the diverticuli causing peridiverticulitis, retroperitoneal abscess and probably abscesses in the liver by haematogenous dissemination. Surgical intervention, resection of the liver and the sigma resulted in recovery of the patient. Difficulties of diagnosis are discussed in the article pointing out the importance of interdisciplinary collaboration, involving also infectologist. Diverticulosis of the sigma as presumably origin of hepatic actinomycosis is a literary curiosity. This was the cause of the case presentation. PMID:21296736

Soós, Zsuzsanna; Bakos, Mária; Kovács, Gábor; Baranyai, László; Jakab, Ferenc; Winkler, Gábor



Amebic liver abscess: Spare the knife but save the child  

Microsoft Academic Search

Background\\/Purpose: Amebic liver abscess (ALA), the most common extraintestinal manifestation of infection with Entameba histolytica, carries significant morbidity and mortality in the pediatric age group. The efficacy of metronidazole in the treatment of ALA is well established, but the role of surgical intervention remains controversial. Many investigators still advocate aggressive surgical therapy for complicated and ruptured ALA. Reports regarding management

F Moazam; Z Nazir



Community-acquired Methicillin-resistant Staphylococcus aureus Prostatic Abscesses.  


: We describe 2 men with prostatic abscesses due to community-acquired methicillin-resistant Staphylococcus aureus. Neither of them had diabetes mellitus, prior prostate disease, recent health care exposure or urinary instrumentation and had no evidence of bloodstream infection at the time of presentation. Both were treated with surgical drainage and prolonged antibiotics. PMID:23689049

Krishnamohan, Prashanth; Schaninger, Takako; Baddour, Larry M; Al-Hasan, Majdi N



Medicolegal cases for spinal epidural hematoma and spinal epidural abscess.  


Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider. The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control. All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases. PMID:23276337

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



Intra-abdominal abscess after penetrating abdominal trauma.  


We reviewed our experience with intra-abdominal abscess after penetrating abdominal trauma. Of a total of 872 laparotomies (1980-1986), 29 patients (0.7% of stab wounds and 6% of gunshot wounds) developed abscesses. Pancreatic and duodenal injuries, in the presence of concomitant colon perforation, were most frequently associated with abscess formation. Fourteen of the 29 patients had multiorgan failure (MOF), Group I, and 15 patients did not have MOF, Group II. Group I had a significantly higher Abdominal Trauma Index (ATI) and Acute Physiology and Chronic Health Evaluation (APACHE II), received greater number of perioperative transfusions and underwent a higher number of reoperations for sepsis than Group II patients. Radiologic imaging techniques were frequently inconclusive for the diagnosis and localization of intra-abdominal abscess in Group I. They were highly accurate in Group II. Fifty per cent of Group I patients died from sepsis and MOF. We conclude that the anatomic (ATI) and the physiologic (APACHE) scores are useful predictors of the potential for uncontrolled sepsis. In the presence of ongoing multiorgan failure, reoperation for sepsis is warranted on clinical grounds alone. PMID:3411646

Ivatury, R R; Zubowski, R; Psarras, P; Nallathambi, M; Rohman, M; Stahl, W M



Management of Bartholin's duct cyst and gland abscess.  


Bartholin's duct cysts and gland abscesses are common problems in women of reproductive age. Bartholin's glands are located bilaterally at the posterior introitus and drain through ducts that empty into the vestibule at approximately the 4 o'clock and 8 o'clock positions. These normally pea-sized glands are palpable only if the duct becomes cystic or a gland abscess develops. The differential diagnosis includes cystic and solid lesions of the vulva, such as epidermal inclusion cyst, Skene's duct cyst, hidradenoma papilliferum, and lipoma. The goal of management is to preserve the gland and its function if possible. Office-based procedures include insertion of a Word catheter for a duct cyst or gland abscess, and marsupialization of a cyst; marsupialization should not be used to treat a gland abscess. Broad-spectrum antibiotic therapy is warranted only when cellulitis is present. Excisional biopsy is reserved for use in ruling out adenocarcinoma in menopausal or perimenopausal women with an irregular, nodular Bartholin's gland mass. PMID:12887119

Omole, Folashade; Simmons, Barbara J; Hacker, Yolanda



[Pleural empyema and lung abscess: current treatment options].  


Parapneumonic pleural empyema has been classified into different stages and classes. While the American Thoracic Society (ATS) classification is based on the natural course of the disease, Light has classified pleural empyema according to the radiological, physical and biochemical characteristics, and the American College of Chest Physician (ACCP) has categorised the patients with pleural empyema according to the risk of a poor outcome. According to this classification the management of the pleural empyema is based on the stage of the disease. Therapeutic strategies include chest tube, chest tube with fibrinolysis, thoracoscopic debridement and decortication in open or minimally invasive techniques. Primary lung abscesses develop in previously healthy lung parenchyma and are caused by aspiration. In addition, abscess formation can occur without aspiration, and important differences relate to community-acquired, nosocomial abscesses and those in the immunosuppressed host. 90 % of all lung abscesses can be cured with antibiotic treatment alone, 10 % have to be treated with an interventional catheter or chest tubes and only 1 % require thoracic surgery because of complications independent of the former conservative or interventional treatment strategies. PMID:22711325

Hecker, E; Hamouri, S; Müller, E; Ewig, S



Isolation of Porphyromonas gingivalis strain from tubal-ovarian abscess.  

PubMed Central

An unusual case of involvement of Porphyromonas gingivalis is described. Two anaerobic isolates, identified as Fusobacterium nucleatum and P. gingivalis, were recovered from the pus of a tubal-ovarian abscess in a 35-year-old woman. Identification of the P. gingivalis isolate was confirmed by randomly amplified polymorphic DNA fingerprinting.

Hirata, R; Menard, C; Fournier, D; Catellani, M A; Mouton, C; Ferreira, M C



Risk of infections subsequent to pyogenic liver abscess: a nationwide population-based study.  


This nationwide study aimed to provide risk estimates for a panel of infections subsequent to pyogenic liver abscesses (PLA) in Taiwan. In this study, we selected 12 050 patients diagnosed with PLA as our study cohort and 60 250 non-PLA patients as our comparison cohort. We individually tracked each subject for a 1-year period beginning with their index date to identify those who were subsequently diagnosed with any of the following infections: pneumonia, endophthalmitis, septic pulmonary embolism, pulmonary abscess, pleural empyema, meningitis, abscess of prostate, renal and perinephric abscess, epidural spinal abscess, osteomyelitis, necrotizing fasciitis, splenic abscess, psoas abscess and infectious endocarditis. We found that during the 1-year follow-up period, the subjects with PLA had a consistently higher incidence of all types of infections than comparison subjects. In particular, compared with subjects without PLA, the adjusted hazard ratios (HR) of pulmonary abscess, pleural empyema, renal and perinephric abscess, epidural spinal abscess and splenic abscess were 26.71, 18.56, 43.21, 51.32 and 126.51, respectively. We further analysed the HR of extra-hepatic Klebsiella pneumoniae infections among patients with PLA caused by K. pneumoniae. We found that the HR was higher for 12 of the 15 analysed extra-hepatic infections after restricting the analysis to only infections with K. pneumoniae aetiologies. PMID:23034092

Keller, J J; Tsai, M-C; Lin, C-C; Lin, Y-C; Lin, H-C



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

SciTech Connect

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.

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



Bacteroides endodontalis and other black-pigmented Bacteroides species in odontogenic abscesses.  

PubMed Central

Twenty-eight odontogenic abscesses were examined for the presence of black-pigmented Bacteroides spp. Of the 28 samples, 26 were found to contain one or more species of black-pigmented Bacteroides. Abscesses were divided into three categories according to the tissue of origin: endodontal, periodontal, and pericoronal. Four abscesses which developed after extraction were also examined. It was found that Bacteroides endodontalis, a newly described species of asaccharolytic black-pigmented Bacteroides, was isolated almost exclusively from periapical abscesses of endodontal origin. B. intermedius proved to be the most frequently isolated species in all of the samples. B. gingivalis was present in all of the periodontal abscesses studied, as well as in two endodontal abscesses. B. melaninogenicus was recovered once from a pericoronal abscess. Precautions for the isolation of B. endodontalis are discussed.

van Winkelhoff, A J; Carlee, A W; de Graaff, J



Behçet's disease complicated by multiple aseptic abscesses of the liver and spleen.  


Aseptic abscesses are an emergent entity and have been described in inflammatory bowel disease, especially in Crohn's disease, and in other diseases. However, aseptic abscesses associated with Behçet's disease are extremely rare. We report a Japanese male diagnosed with an incomplete type of Behçet's disease who developed multiple aseptic abscesses of the spleen and liver. In 2002, the spleen abscesses were accompanied by paroxysmal oral aphthous ulcers and erythema nodosum. As the patient's response to antibiotic treatment was inadequate, a splenectomy was performed. Severe inflammatory cell infiltration, largely of polymorphonuclear neutrophils, was observed without evidence of bacterial or fungal growth. Although the patient had no history of ocular symptoms or genital ulcers, a diagnosis of incomplete Behçet's disease was made according to the Japanese diagnostic criteria because of the presence of paroxysmal arthritis and epididymitis since 2002. In 2005, multiple liver abscesses developed with right hypochondrial pain and seemed to be attributed to Behçet's disease because the abscesses yielded negative results during a microbiologic investigation and failed to go into remission under antibiotic therapy. Oral prednisone (15 mg/d) was started in May 2006, and the abscesses dramatically disappeared 4 wk after treatment. Although the patient had a relapse of the liver abscesses in association with the tapering of prednisone, the augmentation of prednisone dosage yielded a response. The abscesses of the liver and spleen were strongly suggested to be attributed to Behçet's disease. Clinician should be aware of the existence of aseptic abscesses as uncommon manifestations of Behçet's disease. PMID:23717000

Maeshima, Keisuke; Ishii, Koji; Inoue, Megumi; Himeno, Katsuro; Seike, Masataka



[Spinal epidural abscess as a complication of a finger infection].  


An 81-year-old man was treated with intravenous antibiotics for a soft tissue infection in a finger. Despite adequate antibiotic treatment, he developed signs of spinal cord injury caused by a cervical spinal epidural abscess. An emergency laminectomy was performed. The neurological impairment appeared to be irreversible, and the patient died. Spinal epidural abscess is a rare and serious complication ofa bacteraemia. It is often caused by an infection of the skin or soft tissue with Staphylococcus aureus. Given the risk of rapidly progressive and irreversible neurological damage, this complication must be treated as soon as possible. The treatment of choice is surgery. Conservative management with intravenous antibiotics is an option only under strict conditions. PMID:18624007

Ridderikhof, M L; van den Brink, W A; van Dalsen, A D; Kieft, H



Paralaryngeal Abscess with Laryngeal Hemiplegia and Fistulation in a Horse  

PubMed Central

A three year old Thoroughbred filly was examined because of bilateral nasal discharge and external swelling of the left laryngeal area. Endoscopy revealed an enlarged left arytenoid cartilage, left laryngeal hemiplegia and drainage of purulent material into the lumen of the larynx. Radiographs showed a large fluid and gas filled cavity overlying the caudal larynx and cranial trachea. Surgical drainage and debridement of the abscess led to complete healing by secondary intention. Laryngeal ventriculectomy was performed as a treatment for left laryngeal hemiplegia, but a grave prognosis for respiratory soundness was given due to the extensive laryngeal fibrosis. The etiology of the Staphylococcus aureus abscess is unknown but may have originated from oral trauma to the larynx. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.

Barber, S. M.



Paralaryngeal abscess with laryngeal hemiplegia and fistulation in a horse.  


A three year old Thoroughbred filly was examined because of bilateral nasal discharge and external swelling of the left laryngeal area. Endoscopy revealed an enlarged left arytenoid cartilage, left laryngeal hemiplegia and drainage of purulent material into the lumen of the larynx. Radiographs showed a large fluid and gas filled cavity overlying the caudal larynx and cranial trachea. Surgical drainage and debridement of the abscess led to complete healing by secondary intention. Laryngeal ventriculectomy was performed as a treatment for left laryngeal hemiplegia, but a grave prognosis for respiratory soundness was given due to the extensive laryngeal fibrosis. The etiology of the Staphylococcus aureus abscess is unknown but may have originated from oral trauma to the larynx. PMID:7337917

Barber, S M



Descending mediastinitis with mediastinal abscess after supracricoid partial laryngectomy.  


We document a rare and not-yet-reported condition after supracricoid partial laryngectomy: the development of descending mediastinitis with mediastinal abscess. We present a case in which early diagnosis and team management allowed for a successful outcome. The pathophysiology of this severe complication, as well as its diagnosis, management, and prevention, is discussed, together with a review of the medical scientific literature. PMID:23837388

Benito, José; Espinoza, Sophie; Gutiérrez-Fonseca, Raimundo; Bagan, Patrick; Laccourreye, Ollivier



Transphrenic fistulization of a subphrenic abscess to lung parenchyma  

Microsoft Academic Search

A 53-year-old woman was admitted with respiratory distress. For several years, she had chronic alcoholic pancreatitis with\\u000a ductal stones that were treated with a stent and with shockwave lithotripsy. Both treatments were unsuccessful, and the pancreatitis\\u000a was complicated with an infected pseudocyst. The pancreatic head had to be resected, which was complicated with recurrent\\u000a subphrenic abscesses. She then was admitted

Sander Romijn; Maarten Sturm; Georges van der Schelling



Brucella suis Biovar 1 isolated from a hepatic abscess drainage.  


Positive cultures from hepatic abscess drainage are extremely rare, and in this case the infection would have remained undiagnosed if Brucella suis had not been isolated. Failure to correctly diagnose this zoonosis delays patient treatment and is dangerous, as in this case that could have been a laboratory-acquired disease. This type of infection is preventable if proper safety protocols are established and followed. PMID:22448721

Agostinelli, Daniel A; Sánchez de Bustamante, Joaquin; Grendene, Alberto; Barbon, Silvia M; Ayala, Sandra M; Lucero, Nidia E



Sciatic Hernia Mimicking Perianal Abscess in a Cirrhotic Patient  

PubMed Central

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

Andraus, Wellington; Haddad, Luciana Bertocco de Paiva; Ferro, Oscar Cavalcante; D'Albuquerque, Luiz Augusto Carneiro



Necrotizing soft-tissue infection from rectal abscess  

Microsoft Academic Search

Rectal abscess may result in necrotizing soft-tissue infection including fasciitis, myositis, and extraperitoneal dissection\\u000a of pus without muscle necrosis. The presentation and therapy of ten patients treated over the past six years are reviewed.\\u000a \\u000a Early recognition of rapidly spreading infection was imperative. The mortality rate of 40 per cent correlated with the degree\\u000a of sepsis present at admission. The high

Philip Huber; Alfred S. Kissack; C. Thomas Simonton



Two cases of peritonsillar abscess complicated by von Willebrand disease.  


Von Willebrand disease (vWD) is a common hereditary bleeding disorder resulting from a quantitative and/or qualitative deficiency of von Willebrand factor (vWF). We report two cases of peritonsillar abscess complicated by vWD. A 46-year-old Japanese man was intravenously administered factor VIII clotting antigen (500U×3 days)and platelet transfusion (10U), when before puncture was performed. After puncture, his symptoms promptly improved with the administration of the antibiotic doripenem (DRPM, 1.5g/day). He left our facility one week later and had no recurrence of symptoms. A 24-year-old Japanese woman was intravenously administered factor VIII clotting antigen (4500U×3 days) and desmopressin (DDAVP) before undergoing a puncture. Her symptoms promptly improved with DRPM treatment (1.5g/day). The patient left our facility one week later. However, the peritonsillar abscess recurred in three weeks. Afterwards, tonsillectomy was enforced three months later. Intravenous factor VIII clotting antigen (4500U×2 days) and platelet transfusion (10U×1 day) had been used before tonsillectomy. We therefore suggest that a peritonsillar abscess in patients with vWD can be safely treated by factor VIII clotting antigen and DDAVP at the appropriate disease stage and by performing paracentesis for the acute phase or tonsillectomy for the chronic phase. PMID:22075138

Nagano, Hiromi; Harada, Mizue; Umakoshi, Mizuo; Hayamizu, Yoshiko; Yoshifuku, Kosuke; Kurono, Yuichi



Etiology of Persistent Tubo-Ovarian Abscess in Nairobi, Kenya  

PubMed Central

Objective To study the microbial etiology of tubo-ovarian abscess (TOA). Methods We recruited 11 women in Nairobi, Kenya who failed antibiotic therapy alone and required surgical drainage of a presumptive TOA. Pus from the nine abscesses and two pyosalpinges were collected and cultured for aerobic, facultative and anaerobic microorganisms. Results Eleven women suspected of having a TOA were hospitalized and treated for a median of 6 days (range 3–14 days) prior to surgical drainage of the abscess. Nine (82%) specimens were culture positive. Aerobes were present in all nine specimens. Seven of the nine positive cultures (78%) were polymicrobial and five of the polymicrobial cultures contained both anaerobes and aerobes. Anaerobic Gram-negative bacilli (Prevotella sp., Porphyromonas sp. and Bacteroides sp., Escherichia coli ) and Streptococcus sp. ( S. viridans and S. agalactiae) were the most common microorganisms isolated. Neisseria gonorrhoeae and Chlamydia trachomatis were not isolated by culture or detected by polymerase chain reaction. Conclusions In Kenya, persistent TOAs are associated with endogenous flora similar to that normally found in the gastrointestinal tract.

Gravelle, Lisa; Symekher, Samwel; Waiyaki, Peter; Stamm, Walter E.; Kiehlbauch, Julia A.



Neurobrucellosis presenting as an intra-medullary spinal cord abscess  

PubMed Central

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.

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



Nitric Oxide Releasing Nanoparticles Are Therapeutic for Staphylococcus aureus Abscesses in a Murine Model of Infection  

PubMed Central

Staphylococcus aureus (SA) is a leading cause of a diverse spectrum of bacterial diseases, including abscesses. Nitric oxide (NO) is a critical component of the natural host defense against pathogens such as SA, but its therapeutic applications have been limited by a lack of effective delivery options. We tested the efficacy of a NO-releasing nanoparticle system (NO-np) in methicillin-resistant SA (MRSA) abscesses in mice. The results show that the NO-np exert antimicrobial activity against MRSA in vitro and in abscesses. Topical or intradermal NO-np treatment of abscesses reduces the involved area and bacterial load while improving skin architecture. Notably, we evaluated pro- and anti-inflammatory cytokines that are involved in immunomodulation and wound healing, revealing that NO-np lead to a reduction in angiogenesis preventing bacterial dissemination from abscesses. These data suggest that NO-np may be useful therapeutics for microbial abscesses.

Mihu, Mircea Radu; Friedman, Adam J.; Friedman, Joel M.; Nosanchuk, Joshua D.



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

SciTech Connect

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.

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



Obturator internus muscle abscess in children: report of seven cases and review.  


Obturator internus muscle (OIM) abscess is an uncommon entity often mistaken for septic arthritis of the hip. We describe seven children with OIM abscess and review seven previously reported cases. The most common presenting symptoms were hip or thigh pain (14 patients), fever (13), and limp (13). The hip was flexed, abducted, and externally rotated in 11 patients. Magnetic resonance imaging and computed tomography (CT) were diagnostic for OIM abscess in the 14 patients. Associated abscesses were located in the obturator externus muscle (5 patients), psoas muscle (2), and iliac muscle (1). The etiologic agents were Staphylococcus aureus (8 patients), Streptococcus pyogenes (2), Neisseria gonorrhoeae (2), and Enterococcus faecalis (1). Three patients underwent CT-guided percutaneous drainage, and three had surgical drainage. Three patients had ischial osteomyelitis in addition to OIM abscess. The 11 children with uncomplicated OIM abscess were treated for a median of 28 days. All patients had an uneventful recovery. PMID:10028081

Viani, R M; Bromberg, K; Bradley, J S



Nitric oxide releasing nanoparticles are therapeutic for Staphylococcus aureus abscesses in a murine model of infection.  


Staphylococcus aureus (SA) is a leading cause of a diverse spectrum of bacterial diseases, including abscesses. Nitric oxide (NO) is a critical component of the natural host defense against pathogens such as SA, but its therapeutic applications have been limited by a lack of effective delivery options. We tested the efficacy of a NO-releasing nanoparticle system (NO-np) in methicillin-resistant SA (MRSA) abscesses in mice. The results show that the NO-np exert antimicrobial activity against MRSA in vitro and in abscesses. Topical or intradermal NO-np treatment of abscesses reduces the involved area and bacterial load while improving skin architecture. Notably, we evaluated pro- and anti-inflammatory cytokines that are involved in immunomodulation and wound healing, revealing that NO-np lead to a reduction in angiogenesis preventing bacterial dissemination from abscesses. These data suggest that NO-np may be useful therapeutics for microbial abscesses. PMID:19915659

Han, George; Martinez, Luis R; Mihu, Mircea Radu; Friedman, Adam J; Friedman, Joel M; Nosanchuk, Joshua D



Ingestion and pharyngeal trauma causing secondary retropharyngeal abscess in five adult patients.  


Retropharyngeal abscess most commonly occurs in children. When present in adults the clinical features may not be typical, and associated immunosuppression or local trauma can be part of the presentation. We present a case series of five adult patients who developed foreign body ingestion trauma associated retropharyngeal abscess. The unusual pearls of each case, along with their outcomes, are discussed. Pertinent information for the emergency medicine physician regarding retropharyngeal abscess is presented as well. PMID:23326732

Sharma, Sudhir B; Hong, Paul



Vagus indigestion syndrome resulting from a liver abscess in dairy cows.  


A liver abscess resulted in vagal indigestion in 8 dairy cattle. There was cessation of transport of digesta through the omasum. Clinical signs were of variable duration and included abdominal distention and bradycardia. Medical therapy had not been effective. Left paralumbar fossa celiotomy and rumenotomy permitted detection of the liver abscess. A second surgery from a ventral approach allowed drainage of the abscess by insertion of a catheter through the abdominal wall. PMID:4019288

Fubini, S L; Ducharme, N G; Murphy, J P; Smith, D F



New diagnostic and therapeutic techniques in the management of pyogenic liver abscesses.  

PubMed Central

An unexplained increase in the frequency of pyogenic liver abscesses of unknown etiology has, fourtunately, been paralleled by significant advances in diagnostic and therapeutic methods. This report reviews experience with 14 patients operated upon at NYU Medical Center since 1971. Eight cases (57%) were cryptogenic. Other abscesses were associated with biliary disease (3); abdominal sepsis (2); and trauma (1). Abscesses were present on hospitalization in 12 patients. Clinical findings included fever (101-108 F); 100%; leucocytosis, 71%; anorexia and vomiting, 50%; localized tenderness and hepatomegaly, 50%; hypoalbuminemia, 86%; hypocholesterolemia, 78%; elevated SGOT, 71%; and elevated aikaline phosphatase, 43%. Technetium hepatic scintiscans showed focal defects in 10 of 12 patients (83%), but did not detect multiple abscesses in 2 of these. Hepatic arteriography performed in 10 patients was highly accurate, outlining single abscesses in 6 and multiple abscesses in 4. Furthermore, in one patient a false positive scintiscan was demonstrated by negative arteriography, confirmed by autopsy. In 4 patients, arteriography indicated an abscess in the posterior-superior area of the right hepatic lobe. With precise anatomical localization, a trans-thoracic approach permitted uncomplicated drainage in each case. This approach provides excellent exposure and direct drainage for abscesses in this area. An additional therapeutic adjunct in two patients, with 4 and 11 abscesses each, was postoperative intraportal infusion of antibiotics through the umbilical vein. Thirteen patients (83%) recovered, one dying from pulmonary embolism. Primary hepatic abscesses occur with increasing frequency. Primary hepatic abscesses occur with increasing frequency. Primary hepatic abscesses occur with increasing frequency. The methods described allow more precise preoperative diagnosis and direct surgical drainage. Images Fig. 1. Fig. 2.

Ranson, J H; Madayag, M A; Localio, S A; Spencer, F C



Hepatic Abscess That Formed Secondary to Fish Bone and Had a Fistula With the Ascending Colon  

Microsoft Academic Search

We present the case of a liver abscess that formed secondary to foreign bodies and formed a fistula the ascending colon and\\u000a was successfully treated with percutaneous abscess drainage and colonoscopic removal of foreign bodies. A 64-year-old man\\u000a presented with right upper and lower quadrant pain of 2 weeks' duration. Abdominal computed tomography was performed, demonstrating\\u000a a single 3.5×1.9-cm abscess

Yong Moon Kim; Tae Hee Lee; Seung Hyun Jung; Sun Moon Kim; Euyi Hyeog Im; Kyu Chan Huh; Young Woo Choi; Young Woo Kang



An isolated tuberculous liver abscess in a non-immunocompromised patient.  


A liver abscess is an uncommon extra-pulmonary manifestation of a common disease that is tuberculosis. It usually follows primary infection in the lung or the gut. Tuberculous liver abscess in a non-immunocompromised patient in the absence of primary disease elsewhere is an extremely rare occurrence. We report here a case of a tuberculous liver abscess in a 30 years old female who presented a considerable diagnostic challenge. PMID:24034197

Mendis Abeysekera, Walimuni Yohan; Dulantha de Silva, Warusha Dhammika; Ginige, Anusha Prabhamalee; Pragatheswaran, Parameswaran; Hewage, Sachintha Kaushalya; Kumara Banagala, Anura Sarath



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

PubMed Central

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

Sharma, Sudhir B.; Hong, Paul



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

SciTech Connect

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.

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



Retroperitoneal abscess resulting from perforated retrocecal appendicitis:a case report.  


Retroperitoneal abscess secondary to acute appendicitis is a relatively rare, but serious surgical infection. Adequate drainage and coverage with the appropriate antibiotics has led to improved outcome of retroperitoneal abscesses in recent years. We report the case of a 52 years old patient operated in emergency for perforated retrocecal appendicitis. A retroperitoneal abscess was diagnosed 5 days later, by computed tomography. The drainage of the abscess and the antibiotic therapy have ensured the total recovery of the patient. The alternatives of therapy are discussed. PMID:23741936

Ofrim, O I; Legrand, M J


Penile Abscess Secondary to Neglected Penile Fracture after Intracavernosal Vasoactive Drug Injection  

PubMed Central

Penile abscesses are rare, but can develop after trauma, injection therapy, or surgery of the penis, or as an unusual presentation of sexually transmitted diseases. We report a case of penile abscess in a 51-year-old diabetic man, presented 9 days after neglected penile fracture following intracavernosal injection therapy and sexual intercourse. Penile ultrasonography and surgical exploration confirmed the physical examination findings of involvement of the corpus cavernosum. The pus culture from the abscess revealed Enterococcous faecalis. The patient was successfully treated by surgical drainage of the abscess and primary closure of the ruptured tunica albuginea.

Song, Wan; Ko, Kwang Jin; Shin, Seung Jea



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

SciTech Connect

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.

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



En bloc resection of a large tuberculous abscess using the stain plombage procedure.  


En bloc resection is highly recommended for treating tuberculous abscess of the chest wall because of possible recurrence due to microscopic residual lesions; however, complete resection is often difficult. We present a case with a large dumbbell-shaped tuberculous abscess that developed inside and outside the thorax. En bloc resection was successfully achieved using intraoperative closed drainage, ablution, and stain solution plombage procedures, which enabled easy identification of the abscess configuration. When the abscess wall was torn, only minimal solution leakage occurred; therefore, contamination of the surgical field was avoided. We report the procedures we devised and discuss treatments for this obstinate disease. PMID:23272861

Sakakura, Noriaki; Uchida, Tatsuo; Kitamura, Yuka; Suyama, Motokazu



Genetic requirements for Staphylococcus aureus abscess formation and persistence in host tissues  

PubMed Central

Staphylococcus aureus infections are associated with abscess formation and bacterial persistence; however, the genes that enable this lifestyle are not known. We show here that following intravenous infection of mice, S. aureus disseminates rapidly into organ tissues and elicits abscess lesions that develop over weeks but cannot be cleared by the host. Staphylococci grow as communities at the center of abscess lesions and are enclosed by pseudocapsules, separating the pathogen from immune cells. By testing insertional variants in genes for cell wall-anchored surface proteins, we are able to infer the stage at which these molecules function. Fibrinogen-binding proteins ClfA and ClfB are required during the early phase of staphylococcal dissemination. The heme scavenging factors IsdA and IsdB, as well as SdrD and protein A, are necessary for abscess formation. Envelope-associated proteins, Emp and Eap, are either required for abscess formation or contribute to persistence. Fluorescence microscopy revealed Eap deposition within the pseudocapsule, whereas Emp was localized within staphylococcal abscess communities. Antibodies directed against envelope-associated proteins generated vaccine protection against staphylococcal abscess formation. Thus, staphylococci employ envelope proteins at discrete stages of a developmental program that enables abscess formation and bacterial persistence in host tissues.—Cheng, A. G., Kim, H. K., Burts, M. L., Krausz, T., Schneewind, O., Missiakas, D. M. Genetic requirements for Staphylococcus aureus abscess formation and persistence in host tissues.

Cheng, Alice G.; Kim, Hwan Keun; Burts, Monica L.; Krausz, Thomas; Schneewind, Olaf; Missiakas, Dominique M.



Abscess formation associated with pituitary adenoma: A case report: Changes in the MRI appearance of pituitary adenoma before and after abscess formation  

PubMed Central

Background: Pituitary abscess is an extremely rare finding. The abscess may arise as a primary pituitary lesion or be associated with parasellar pathology. It is important for pituitary abscess treatments to perform early diagnosis. In this report, we describe a case of pituitary adenoma in which MRI findings changed during the follow-up period and strongly suggested progression to pituitary abscess arising from adenoma. Case Description: In a 73-year-old female, pituitary adenoma had been incidentally detected; MRI showed typical findings of pituitary adenoma, and we had followed up the pituitary lesion and clinical symptoms. Six months later, she had oculomotor nerve palsy and symptoms of hypopituitarism. Hematological examination revealed inflammation and hypopituitarism. MRI showed striking changes in the signal intensity of the pituitary lesion, and strongly suggested occurrence of sinusitis and pituitary abscess ascribed to pituitary adenoma. She was admitted and endoscopic transsphenoidal surgery was performed. The sellar floor was destroyed, and yellowish-white creamy pus was observed. A histopathological study using hematoxylin-eosin staining showed adenoma and inflammatory cells. Aerobic, anaerobic, and fungal cultures were negative. Antibiotics were administered and hormonal replacement was started. Neurological and general symptoms were improved, and postoperative MRI revealed complete evacuation of abscess and removal of tumor. Conclusions: Pituitary abscess within invasive pituitary adenoma is a rare entity, and shows high mortality. Early diagnosis of pituitary abscess is very important for the prompt surgery and initiation of treatment with antibiotics. In our case, changes in MRI findings were helpful to diagnose pituitary abscess, and endoscopic transsphenoidal surgery was an optimal surgical treatment.

Kuge, Atsushi; Sato, Shinya; Takemura, Sunao; Sakurada, Kaori; Kondo, Rei; Kayama, Takamasa



[Liver abscess and infective endocarditis cases caused by Ruminococcus productus].  


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

Sucu, Nurgün; Köksal, Iftihar; Yilmaz, Gürdal; Aydin, Kemalettin; Caylan, Rahmet; Aktoz Boz, Gönülden



Does an Infected Peripancreatic Fluid Collection or Abscess Mandate Operation?  

PubMed Central

Objective To assess the treatment of peripancreatic fluid collections or abscess with percutaneous catheter drainage (PCD). Summary Background Data Surgical intervention has been the mainstay of treatment for infected peripancreatic fluid collections and abscesses. Increasingly, PCD has been used, with mixed results reported in the literature. Methods A retrospective chart review of 1993 to 1997 was performed on 82 patients at a tertiary care public teaching hospital who had computed tomography-guided aspiration for suspected infected pancreatic fluid collection or abscess. Culture results, need for subsequent surgical intervention, length of stay, and death rate were assessed. Results One hundred thirty-five aspirations were performed in 82 patients (57 male patients, 25 female patients) with a mean age of 40 years (range 17–68). The etiologies were alcohol (41), gallstones (32), and other (9). The mean number of Ranson’s criteria was four (range 0–9). All patients received antibiotics. Forty-eight patients had evidence of pancreatic necrosis on computed tomography scan. Cultures were negative in 40 patients and positive in 42. Twenty-five of the 42 culture–positive patients had PCD as primary therapy, and 6 required subsequent surgery. Eleven patients had primary surgical therapy, and five required subsequent surgery. Six patients were treated with only antibiotics. The death rates were 12% for culture-positive patients and 8% for the entire 82 patients. Conclusions Historically, patients with positive peripancreatic aspirate culture have required operation. This series reports an evolving strategy of reliance on catheter drainage. PCD should be considered as the initial therapy for culture-positive patients, with surgical intervention reserved for patients in whom treatment fails.

Baril, Nicole B.; Ralls, Philip W.; Wren, Sherry M.; Selby, R. Rick; Radin, Randall; Parekh, Dilip; Jabbour, Nicolas; Stain, Steven C.



Endogenous endophthalmitis associated with liver abscess caused by Klebsiella pneumoniae.  


To report two unusual cases of endogenous endophthalmitis associated with liver abscess caused by Klebsiella pneumoniae. Retrospective, interventional case series. Two patients, known to have type II diabetes mellitus, presented with sudden visual loss following several days of abdominal pain. Examinations and investigations revealed endogenous endophthalmitis caused by K. pneumoniae. Despite treatment in the form of intravitreal injection of antibiotics in the first patient and pars plana vitrectomy coupled with intravitreal injection of antibiotics in the second patient the final visual outcome was poor in both cases. The possibility of K. pneumoniae endogenous endophthalmitis should be suspected in diabetic patients presenting with intraocular inflammation. PMID:21264489

Al-Mahmood, Ammar M; Al-Binali, Ghada Y; Alkatan, Hind; Abboud, Emad B; Abu El-Asrar, Ahmed M



The warm sacroiliac joint. A finding in pelvic abscess  

SciTech Connect

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.

Slavin, J.D. Jr.; Epstein, N.; Negrin, J.A.; Spencer, R.P. (Saint Francis Hospital and Medical Center, Hartford, CT (USA))



The risk of abscess from sternoclavicular septic arthritis.  


From a systematic review of the literature on septic arthritis and our own patient records we found that in a high percentage of cases (20% of those we reviewed) infection of the sternoclavicular joint leads to an abscess. This appears to be true regardless of the presence or absence of a history of intravenous drug abuse or underlying illness compromising the immune system, and regardless of the responsible organism. The predisposing factors must center on the joint itself. The risk from spread of infection should be considered in management of the uncommon but difficult clinical problem of sternoclavicular septic arthritis. PMID:3054098

Wohlgethan, J R; Newberg, A H; Reed, J I



An uncommon cause of recurrent pyogenic meningitis: pituitary abscess  

PubMed Central

The authors report a 36-year-old male who presented with headache and hypopituitarism, and MRI revealed a ring enhancing lesion with pituitary stalk thickening. During follow-up, he presented with recurrent pyogenic meningitis with persistence of the lesion, therefore a diagnosis of pituitary abscess was considered. He underwent trans-sphenoidal surgery (TSS) with evacuation of pus and received antibiotic treatment for the same. After this he remarkably improved and had no recurrence of symptoms. He is on levothyroxine, glucocorticoids and testosterone replacement therapy for his respective hormone deficits.

Walia, Rama; Bhansali, Anil; Dutta, Pinaki; Shanmugasundar, G; Mukherjee, Kanchan Kumar; Upreti, Vimal; Das, Ashim



Primary pituitary tubercular abscess mimicking as pituitary adenoma  

PubMed Central

Tubercular abscess of the pituitary fossa is rare and may lead to diagnostic uncertainty in a patient with absence of tuberculosis elsewhere in the body. We present a rare case report of a young lady who presented with sellar and suprasellar cystic mass. She was diagnosed as a case of pituitary macroadenoma and was intraoperatively found to harbor pus in the lesion. She did not have any symptoms of infection. The case underlines the importance of considering such a possibility in the differential diagnosis of cystic sellar lesions and further diagnostic tests should be done for confirmation and treatment of this rare and potential life threatening illness.

Ranjan, Rakesh; Agarwal, Pankaj; Ranjan, Shweta



[Persistent swelling after flushing of an abscess with Octenisept®].  


We report the case of a long-lasting cutaneous side effect after inappropriate use of Octenisept® solution (containing octenidine and phenoxyethanol). Following lavage of an abscess in the inguinal region, a painful erythematous induration mimicking cellulitis persisted for several months. Manual lymphatic drainage considerably improved the symptoms. Octenisept® shows considerable tissue toxicity in vivo including - but not restricted to - blood vessel damage. Deterioration of endothelial cells followed by oedema and continued tissue damage can be seen histologically. Despite the fact that there is a circular letter issued by the manufacturer as well as a boxed warning on the bottles, the awareness to avoid this misuse of Octenisept® is still lacking. PMID:22101779

Bauer, B; Majic, M; Rauthe, S; Bröcker, E-B; Kerstan, A



Azithromycin in an experimental Staphylococcus aureus abscess model.  


We studied the efficacy and pharmacokinetics of azithromycin in a rabbit tissue-cage Staphylococcus aureus abscess model. A dosage of 15 mg/kg/day azithromycin was administered to rabbits with 24 h or 2 week old infected tissue cages and to uninfected controls. Concentrations of azithromycin were higher in the infected compared with the uninfected tissue cages. Azithromycin was effective in reducing the bacterial concentrations in both groups of infected tissue cages by approximately 3 log10 cfu/mL compared with untreated controls after 8 days of therapy. Fifty percent of the 24 h and 29% of the 2 week infected tissue cages became culture-negative. PMID:7592175

Bamberger, D M; Herndon, B L; Suvarna, P R



Genome Sequence of the Human Abscess Isolate Streptococcus intermedius BA1  

PubMed Central

Streptococcus intermedius is a human pathogen with a propensity for abscess formation. We report a high-quality draft genome sequence of S. intermedius strain BA1, an isolate from a human epidural abscess. This sequence provides insight into the biology of S. intermedius and will aid investigations of pathogenicity.

Planet, Paul J.; Rampersaud, Ryan; Hymes, Saul R.; Whittier, Susan; Della-Latta, Phyllis A.; Narechania, Apurva; Daugherty, Sean C.; Santana-Cruz, Ivette; DeSalle, Robert; Ravel, Jacques



Outbreaks of Group A Streptococcal Abscesses Following Diphtheria-Tetanus Toxoid-Pertussis Vaccination  

Microsoft Academic Search

Two outbreaks of group A streptococcal abscesses following receipt of diphtheria-tetanus toxoid-pertussis (DTP) vaccine from different manufacturers were reported to the Centers for Disease Control (CDC) in 1982. The clustering of the immunization times of cases, the isolation of the same serotype of Streptococcus from all cases in each outbreak, and the absence of reported abscesses associated with receipt of

Harrison C. Stetler; Paul L. Garbe; Diane M. Dwyer; Richard R. Facklam; Walter A. Orenstein; Gary R. West; K. Joyce Dudley; Alan B. Bloch


Iliopsoas abscess: Analysis and perspectives from an endemic region of Eastern Nepal  

Microsoft Academic Search

Objective: To evaluate the clinical profile and outcome in patients with iliopsoas abscess. Methods: A descriptive study was carried out in B.P. Koirala Institute of Health Science, Dharan, Nepal from February 2005 to March 2006. The medical records of all thirty six patients admitted in surgery ward with diagnosis of iliopsoas abscess during the study period were analyzed. Results: Thirty

Yadav RP; Agrawal CS; Adhikary S; Kumar M; Regmi R; Amatya R; Gupta RK


Acute Pyogenic Iliopsoas Abscess in Taiwan: Clinical Features, Diagnosis, Treatments and Outcome  

Microsoft Academic Search

Objectives: To study the variations of aetiology in the patients with acute pyogenic iliopsoas abscess and identify the appropriate diagnostic modalities as well as therapeutic alternatives (e.g. extraperitoneal or retrofascial percutaneous catheter drainage, PCD) other than surgery.Methods: We carried out a retrospective review and analysis of 25 patients with acute pyogenic iliopsoas abscess in our institution from August 1988 to

J.-J Huang; M.-K Ruaan; R.-R Lan; M.-C Wang



Primary Skin Abscesses Are Mainly Caused by Panton-Valentine Leukocidin-Positive Staphylococcus aureus Strains  

Microsoft Academic Search

Background: The role of Panton-Valentine leukocidin (PVL) in skin and soft-tissue infections is not clear. Objective: Our purpose was to determine the prevalence of PVL gene carriage among Staphylococcus aureus strains isolated from primary and secondary skin abscesses. Methods: A prospective study was conducted. From July 2003 to June 2008, S. aureus isolates from skin abscesses were screened for the

Pascal del Giudice; Véronique Blanc; Alexis de Rougemont; Michčle Bes; Gérard Lina; Thomas Hubiche; Laurent Roudičre; François Vandenesch; Jérôme Etienne



Ultrasonographic findings in five cows before and after treatment of reticular abscesses.  


Five cows with reticular abscesses were examined clinically, haematologically, radiographically and ultrasonographically. They all had clinical signs typical of traumatic reticuloperitonitis, including chronic indigestion, pyrexia, an absence of or reduced ruminal motility, weight loss and a positive reaction to foreign body test. A haematological examination revealed anaemia, increased concentrations of plasma protein and fibrinogen and a decreased clotting time in the glutaraldehyde test. On the basis of the radiographic examination, a tentative diagnosis of reticular abscess was made in four of the cows, because the reticulum was displaced from the peritoneum or because there was an extensive gas-fluid interface in the reticular region. By ultrasonography, a large reticular abscess with a well developed capsule was visible in each of the cows. The abscess was located between the reticulum and ventral peritoneum in two of them, between the reticulumn and right thoracic wall in two and between the reticulum and spleen in the other cow. A foreign body penetrating the abscess could be visualised ultrasonographically in one cow. In two cows, the abscesses were drained through an ultrasound-guided transcutaneous incision. In the other three cows, the abscess was incised and drained from within the reticulum during a rumenotomy. Ultrasonographic examination revealed that the abscess had been completely evacuated in four cows, but only by about two-thirds in the remaining cow. All the cows were clinically healthy when they were discharged. PMID:9533280

Braun, U; Iselin, U; Lischer, C; Fluri, E



A community-acquired methicillin-resistant Staphylococcus aureus liver abscess  

Microsoft Academic Search

A pyogenic liver abscess is a major hepatobiliary infection that carries significant morbidity and mortality. The dominant aetiology has changed over the years, from suppurative appendicitis during the era before antibiotic usage to different hepatobiliary and colonic pathologies in recent years. These abscesses are usually polymicrobial, with Escherichia coli, Klebsiella species and Bacteroides the most common pathogens. Most can be

Vivien WY Wong; YS Cheung; John Wong; KF Lee; Paul BS Lai



A Novel Virulence Gene in Klebsiella pneumoniae Strains Causing Primary Liver Abscess and Septic Metastatic Complications  

Microsoft Academic Search

Primary Klebsiella pneumoniae liver abscess complicated with metastatic meningitis or endophthalmi- tis is a globally emerging infectious disease. Its pathogenic mechanism remains unclear. The bacterial virulence factors were explored by comparing clinical isolates. Differences in muco- viscosity were observed between strains that caused primary liver abscess (invasive) and those that did not (noninvasive). Hypermucoviscosity correlated with a high serum resistance

Chi-Tai Fang; Yi-Ping Chuang; Chia-Tung Shun; Shan-Chwen Chang; Jin-Town Wang


Management of adult superficial acute abscesses in a tertiary hospital: time for incisive action  

Microsoft Academic Search

Aim Reduction in length of inpatient stay is an important factor in reducing healthcare costs in many hospital systems. This paper examines trends in hospital stay over time for general surgical patients presenting with abscess, and outlines the potential benefits if a day case service for acute abscess procedures was established. Method Retrospective review of Otago Surgical Audit data from

Jannah Baker; John Windsor


First report of liver abscess caused by Salmonella enterica serovar Dublin.  


This is the first reported case of liver abscess attributable to Salmonella serovar Dublin infection and also the fourth case of Salmonella liver abscess complicated with hepatocellular carcinoma reported since 1990. Drainage combined with intravenous antibiotics resulted in improvement, but recovery regressed again. Subsequent hepatic left lobectomy led to full recovery. PMID:23784127

Qu, Fen; Fan, Zhenping; Cui, Enbo; Zhang, Wenjin; Bao, Chunmei; Chen, Suming; Mao, Yuanli; Zhou, Dongsheng



[Disentery and hepatic abscess in the colonial and republican Chile. Doctor Miguel Claro Vásquez].  


The frequency and severity of dysentery and hepatic abscess during the colonial and republican era in Chile are reviewed. The amebian etiology was confirmed in both clinical entities. Also, Miguel Claro Vásquez, physician and later priest and bishop of the Catholic Church, was distinguished for his contribution to hepatic abscess surgery. PMID:20140320

Laval R, Enrique



Bilateral lung abscesses in a 9-month-old healthy infant.  


Multiple lung abscesses are extremely rare in healthy children. We report a case of polymicrobial bilateral lung abscess in a 9-month-old previously well infant presenting with a short history of fever and respiratory distress. The management options and outcome are discussed. PMID:22315634

Kulkarni, Ketan; Bakshi, Anita S; Jerath, Nameet



Klebsiella pneumoniae K1 Liver Abscess and Septic Endophthalmitis in a U.S. Resident  

PubMed Central

Klebsiella pneumoniae K1 is a major agent of hepatic abscess with metastatic disease in East Asia, with sporadic reports originating elsewhere. We report a case of abscess complicated by septic endophthalmitis caused by a wzyAKpK1-positive Klebsiella strain in a U.S. resident, raising concern for global emergence.

Sachdev, Darpun D.; Yin, Michael T.; Horowitz, Jason D.; Mukkamala, Sri Krishna; Lee, Song Eun



Gynecologic rarities: a case of periclitoral abscess and review of the literature.  


Periclitoral abscess is a rare entity, with publications limited to case reports. We present here a case of periclitoral abscess in a 17 year old patient, which was treated with incision and drainage. We also review all the similar cases that have been reported in the English literature until now. PMID:22975589

Koussidis, George A



Successful medical management of prosthetic-valve endocarditis complicated by perivalvular abscess  

Microsoft Academic Search

We present a case of a 44-year-old man with prosthetic aortic endocarditis complicated by a perivalvular abscess that was spontaneously drained into the left ventricular chamber. He had a history of rheumatic fever and had previously been submitted to three valve replacements because of biological prosthesis dysfunction and infective endocarditis. We briefly discuss the main features of paravalvular abscess complicating

Maria do Carmo; Pereira NUNES; Claudio Leo GELAPE; Felipe Batista; Lima BARBOSA; Luciano Ribeiro LEDUC; Christiano Gonçalves de ARAÚJO; Lucas Fabel CHALUP; Marcela Ferreira; Teresa Cristina; Abreu FERRARI


Ventriculo-peritoneal shunt: A rare cause of basal ganglia and thalamic abscess  

PubMed Central

We report an 18-month-old female child with ventriculo-peritoneal shunt related thalamic abscess treated with stereotactic aspiration. Deep seated abscesses are complex due to difficult access and are associated with an increased risk of intra-ventricular rupture as well as antibiotic resistance, a fact which justifies a more aggressive and immediate neurosurgical management.

Sangwan, Parvesh; Saikia, Bhaskar; Sharma, Pradeep Kumar; Sharma, Rachna; Khilnani, Praveen



Nocardia nova as the Causative Agent in Spondylodiscitis and Psoas Abscess?  

PubMed Central

We describe here the first case of Nocardia nova spondylodiscitis accompanied by a psoas abscess due to spreading from pulmonary nocardiosis. Nocardia was cultured from all affected sites. After 1 year of an appropriate antimicrobial therapy and a surgical drainage of the abscess that was required, the patient's clinical condition had improved.

Hamdad, Farida; Vidal, Barbara; Douadi, Youcef; Laurans, Genevieve; Canarelli, Brigitte; Choukroun, Gabriel; Rodriguez-Nava, Veronica; Boiron, Patrick; Beaman, Blaine; Eb, Francois



Genetic requirements for Staphylococcus aureus abscess formation and persistence in host tissues.  


Staphylococcus aureus infections are associated with abscess formation and bacterial persistence; however, the genes that enable this lifestyle are not known. We show here that following intravenous infection of mice, S. aureus disseminates rapidly into organ tissues and elicits abscess lesions that develop over weeks but cannot be cleared by the host. Staphylococci grow as communities at the center of abscess lesions and are enclosed by pseudocapsules, separating the pathogen from immune cells. By testing insertional variants in genes for cell wall-anchored surface proteins, we are able to infer the stage at which these molecules function. Fibrinogen-binding proteins ClfA and ClfB are required during the early phase of staphylococcal dissemination. The heme scavenging factors IsdA and IsdB, as well as SdrD and protein A, are necessary for abscess formation. Envelope-associated proteins, Emp and Eap, are either required for abscess formation or contribute to persistence. Fluorescence microscopy revealed Eap deposition within the pseudocapsule, whereas Emp was localized within staphylococcal abscess communities. Antibodies directed against envelope-associated proteins generated vaccine protection against staphylococcal abscess formation. Thus, staphylococci employ envelope proteins at discrete stages of a developmental program that enables abscess formation and bacterial persistence in host tissues. PMID:19525403

Cheng, Alice G; Kim, Hwan Keun; Burts, Monica L; Krausz, Thomas; Schneewind, Olaf; Missiakas, Dominique M



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


The deceased was an unidentified young male found unconscious on a walkway. On autopsy, outer and inner fistulae of the left temporal bone, subcutaneous abscess in the left side of the neck and head, and an intracranial abscess were noted. A portion of the left temporal bone was removed and scanned by cone-beam computed tomography (CT) (normally used for dentistry applications) to evaluate the lesion. The cone-beam CT image revealed roughening of the bone wall and hypolucency of the mastoid air cells, consistent with an inflammatory bone lesion. According to autopsy and imaging findings, the cause of death was diagnosed as intracranial abscess with Bezold's abscess secondary to left mastoiditis as a complication of otitis media. Although determining the histopathology of bone specimens is time-consuming and costly work, we believe that use of cone-beam CT for hard tissue specimens can be useful in forensic practice. PMID:24112990

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



Pyogenic Liver Abscess with a Focus on Klebsiella pneumoniae as a Primary Pathogen: An Emerging Disease with Unique Clinical Characteristics  

Microsoft Academic Search

OBJECTIVES:Pyogenic liver abscess is a common intraabdominal infection. Historically, Escherichia coli (E. coli) has been the predominant causative agent. Klebsiella liver abscess (KLA) was first reported in Taiwan and has surpassed E. coli as the number one isolate from patients with hepatic abscesses in that country and reports from other countries, including the United States, have increased. We examined the

Edith R. Lederman; Nancy F. Crum



Nasal septal abscess complicating isolated acute sphenoiditis: case report and literature review.  


This report presents an extremely rare case of nasal septal abscess complicating acute sphenoiditis in a non-immunocompromised adult patient. A 56-year-old woman came to our emergency service with a 2 wk history of nasal obstruction, headache, and facial pain. A nontraumatic nasal septal abscess complicating acute isolated sphenoiditis was diagnosed. Under general anaesthesia, we drained the septal abscess and performed an endoscopic transnasal sphenoidotomy. Bacteriological cultures revealed viridans streptococci in the septal abscess and sphenoid cavity. We discuss the patient's diagnosis, possible complications, and treatment. There are limited reports in the literature on this subject. Our report emphasizes the need to determine whether an infection is associated with a non-traumatic nasal septal abscess. The incidence of severe complications is directly related to delays in diagnosis and treatment. Therefore, a prompt and correct diagnosis immediately followed by appropriate treatment is necessary. PMID:21302696

Gradoni, P; Fois, P



Beh?et's disease complicated by multiple aseptic abscesses of the liver and spleen  

PubMed Central

Aseptic abscesses are an emergent entity and have been described in inflammatory bowel disease, especially in Crohn’s disease, and in other diseases. However, aseptic abscesses associated with Behçet’s disease are extremely rare. We report a Japanese male diagnosed with an incomplete type of Behçet’s disease who developed multiple aseptic abscesses of the spleen and liver. In 2002, the spleen abscesses were accompanied by paroxysmal oral aphthous ulcers and erythema nodosum. As the patient’s response to antibiotic treatment was inadequate, a splenectomy was performed. Severe inflammatory cell infiltration, largely of polymorphonuclear neutrophils, was observed without evidence of bacterial or fungal growth. Although the patient had no history of ocular symptoms or genital ulcers, a diagnosis of incomplete Behçet’s disease was made according to the Japanese diagnostic criteria because of the presence of paroxysmal arthritis and epididymitis since 2002. In 2005, multiple liver abscesses developed with right hypochondrial pain and seemed to be attributed to Behçet’s disease because the abscesses yielded negative results during a microbiologic investigation and failed to go into remission under antibiotic therapy. Oral prednisone (15 mg/d) was started in May 2006, and the abscesses dramatically disappeared 4 wk after treatment. Although the patient had a relapse of the liver abscesses in association with the tapering of prednisone, the augmentation of prednisone dosage yielded a response. The abscesses of the liver and spleen were strongly suggested to be attributed to Behçet’s disease. Clinician should be aware of the existence of aseptic abscesses as uncommon manifestations of Behçet’s disease.

Maeshima, Keisuke; Ishii, Koji; Inoue, Megumi; Himeno, Katsuro; Seike, Masataka



[Huge dorsolumbar cold abscess associated with Pott's disease].  


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

Rakotoson, J L; Rakotomizao, J R; Andrianarisoa, A C F



Peritonsillar abscess after tonsillectomy: a review of the literature  

PubMed Central

INTRODUCTION Peritonsillar abscess (PTA) is a common condition with a complicated aetiology. PTA after tonsillectomy is rare. This literature review of PTA in the absence of tonsil tissue aims to collate experience of these cases and examine the wider implications for understanding the aetiology of PTA formation. METHODS A structured literature review was performed using Ovid MEDLINE®. Keywords ‘quinsy’ or ‘peritonsillar abscess’ were combined with ‘tonsillectomy’. RESULTS The search resulted in 212 citations and the identification of 11 cases of PTA formation in the absence of tonsil tissue. The most common indication for tonsillectomy was recurrent tonsillitis or PTA. Nine patients had no interval peritonsillar infection (ie a peritonsillar infection after a tonsillectomy) prior to presenting with the PTA. The mean interval between tonsillectomy and PTA was 16 years. All patients were managed either by incision and drainage or by needle aspiration with or without antibiotics. CONCLUSIONS PTA in the absence of tonsil tissue is rare. Potential sources of infection include congenital branchial fistulas, Weber's glands and dental disease. These alternatives should also be considered in patients presenting with PTA formation in the absence of concurrent tonsillitis and may influence management decisions.

Farmer, SEJ; Khatwa, MA; Zeitoun, HMM



Intra-abdominal abscess unassociated with prior operation.  


During the past five years, 65 patients were treated for intra-abdominal abscesses unassociated with prior operation. Radiologic tests proved quite accurate in confirming the diagnosis. Abdominal x-ray films were abnormal in 25 (57%) of 44 patients, as were ultrasonograms in 33 (89%) of 37 patients, computed tomography scans in 13 (100%) of 13 patients, and gallium scans in five (100%) of five patients. Celiotomy was performed in each patient with both abscess drainage and the appropriate management of the diseased organ. Seven patients (10.8%) died, and in five death was due to uncontrolled sepsis. Duration of hospitalization averaged 23 days (seven days preoperatively and 16 days postoperatively). Twenty-two (34%) of 65 patients had an incorrect preoperative diagnosis leading to prolonged antibiotic treatment and delay in operation. The mortality was significant in seven (10.8%) of 65 patients, unrelated to the type of operative drainage (Penrose v sump) but clearly related to uncontrolled intra-abdominal sepsis. A heightened suspicion of this problem should allow for an earlier diagnosis and an improved outcome. Prompt abdominal reexploration is indicated in those patients manifesting continued evidence of sepsis or organ failure. PMID:4015374

Field, T C; Pickleman, J



Gram Staining for the Treatment of Peritonsillar Abscess  

PubMed Central

Objective. To examine whether Gram staining can influence the choice of antibiotic for the treatment of peritonsillar abscess. Methods. Between 2005 and 2009, a total of 57 cases of peritonsillar abscess were analyzed with regard to cultured bacteria and Gram staining. Results. Only aerobes were cultured in 16% of cases, and only anaerobes were cultured in 51% of cases. Mixed growth of aerobes and anaerobes was observed in 21% of cases. The cultured bacteria were mainly aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. Phagocytosis of bacteria on Gram staining was observed in 9 cases. The bacteria cultured from these cases were aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. The sensitivity of Gram staining for the Gram-positive cocci and Gram-negative rods was 90% and 64%, respectively. The specificity of Gram staining for the Gram-positive cocci and Gram-negative rods was 62% and 76%, respectively. Most of the Gram-positive cocci were sensitive to penicillin, but some of anaerobic Gram-negative rods were resistant to penicillin. Conclusion. When Gram staining shows only Gram-positive cocci, penicillin is the treatment of choice. In other cases, antibiotics effective for the penicillin-resistant organisms should be used.

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



Comparison of outcomes in patients with active infective endocarditis with versus without paravalvular abscess and with and without valve replacement.  


In 82 patients with infective endocarditis, including 11 with a perivalvular abscess detected by transesophageal echocardiography, age was a significant predictor of in-hospital mortality (p <0.001). At 3.8-year follow-up, 5 of 7 patients with an abscess who had valve replacement and 2 of 4 patients with an abscess who did not have surgery survived (p = NS); 13 of 22 patients (59%) with no abscess who had valve replacement and 20 of 49 patients (41%) with no abscess who did not have surgery survived (p = NS). PMID:15219527

Langiulli, Michael; Salomon, Pierre; Aronow, Wilbert S; McClung, John A; Belkin, Robert N



Systemic antibiotics after incision and drainage of simple abscesses: a meta-analysis.  


BACKGROUND: Over the last decade, there has been a significant increase in the number of cutaneous abscesses. While there is general agreement that abscesses should be treated with incision and drainage, it is unclear whether systemic antibiotics should be routinely prescribed. OBJECTIVE: To evaluate whether systemic antibiotics, when compared with a placebo, improve cure rates in patients with simple abscesses after incision and drainage. METHODS DESIGN: Systematic review and meta-analysis using RevMan5. PATIENTS AND SETTINGS: Children and adults with simple abscesses treated in outpatient clinics or emergency departments. DATA SOURCES: Cochrane Central, Medline, Embase and bibliographies. OUTCOME MEASURES: Percentage of patients with complete resolution of abscess without the need for recurrent incision and drainage, additional antibiotics, or hospital admission within 7-10 days of treatment. RESULTS: We included four trials, consisting of 589 patients in total (428 adults and 161 children). Patients were randomised to one of three antibiotics (cephridine (27), cephalexin (82), or trimethoprim sulfamethoxazole (161)) or to placebo (285), with 34 lost to follow-up or having incomplete data. When given in addition to incision and drainage, systemic antibiotics did not significantly improve the percentage of patients with complete resolution of their abscesses 7-10 days after treatment (88.1% vs 86.0%; OR 1.17 (95% CI 0.70 to 1.95)). CONCLUSIONS: When given in addition to incision and drainage, systemic antibiotics do not significantly improve the percentage of patients with complete resolution of their abscesses. PMID:23686731

Singer, Adam J; Thode, Henry C



Potentially Life-Threatening Neck Abscesses: Therapeutic Management Under CT-Guided Drainage  

SciTech Connect

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.

Thanos, L., E-mail:; Mylona, S.; Kalioras, V.; Pomoni, M.; Batakis, Nikolaos ['Korgialeneio-Benakeio', Red-Cross Hospital of Athens, Department of Radiology (Greece)



Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses: a Ugandan experience  

PubMed Central

Background Despite breast abscess becoming less common in developed countries, it has remained one of the leading causes of morbidity in women in developing countries. A randomized controlled trial was conducted at Mulago hospital complex in Kampala Uganda to establish whether ultrasound guided needle aspiration is a feasible alternative treatment option for breast abscesses. Results A total of 65 females with breast abscess were analyzed, of these 33 patients were randomized into the ultrasound guided needle aspiration and 32 patients in the Incision and drainage arm. The mean age was 23.12, most of them were lactating (66.2%), primipararous (44.6%) with peripheral abscesses (73.8%) located in the upper lateral quadrant (56%).The mean breast size was 3.49 cm. The two groups were comparably in demographic characteristic and breast abscess size. Survival analysis showed no difference in breast abscess healing rate between the two groups (Log rank 0.24 df 1 and P = 0.63). Incision and drainage was found to be more costly than ultrasound guided aspiration (cost effective ratio of 2.85). Conclusion Ultrasound guided needle aspiration is therefore a feasible and cost effective treatment option for both lactating and non lactating breast abscesses with a diameter up to 5 cm by ultrasound in an immune competent patient



Abscess of the caudate lobe of the liver, a rare disease with a challenging management: a case report.  


We reported a rare case of abscess of the caudate lobe of the liver in a 60-year old man. We first tried computed tomography (CT) guided percutaneous drainage of the abscess but failed to eradicate the infection. Deterioration of the general condition of the patient necessitated open surgical drainage, which resulted in cure of the abscess. The peculiar anatomical location of caudate lobe abscess introduces a great challenge for the surgeon in planning the appropriate management and paucity of patients with caudate lobe abscess has led to lack of guidelines for management. The non-operative interventional radiology approach has become the therapeutic choice for pyogenic liver abscess, but is it applicable also for caudate lobe abscess? PMID:24086176

Al Amer, Nasser A; Abd El Maksoud, Walid M



Abscess of the caudate lobe of the liver, a rare disease with a challenging management: a case report  

PubMed Central

We reported a rare case of abscess of the caudate lobe of the liver in a 60-year old man. We first tried computed tomography (CT) guided percutaneous drainage of the abscess but failed to eradicate the infection. Deterioration of the general condition of the patient necessitated open surgical drainage, which resulted in cure of the abscess. The peculiar anatomical location of caudate lobe abscess introduces a great challenge for the surgeon in planning the appropriate management and paucity of patients with caudate lobe abscess has led to lack of guidelines for management. The non-operative interventional radiology approach has become the therapeutic choice for pyogenic liver abscess, but is it applicable also for caudate lobe abscess?

Al Amer, Nasser A.; Abd El Maksoud, Walid M.



Diagnostic assessment of brain tumours and non-neoplastic brain disorders in vivo using proton nuclear magnetic resonance spectroscopy and artificial neural networks  

Microsoft Academic Search

Purpose\\u000a : Experiments were carried out to assess the potential of artificial neural network (ANN) analysis in the differential diagnosis\\u000a of brain tumours (low- and high-grade gliomas) from non-neoplastic focal brain lesions (tuberculomas and abscesses), using\\u000a proton magnetic resonance spectroscopy (1H MRS) as input data. Methods\\u000a : Single-voxel stimulated echo acquisition mode (STEAM) (echo time of 20?ms) spectra were acquired

Harish Poptani; Jouni Kaartinen; Rakesh K. Gupta; Matthias Niemitz; Yrjö Hiltunen; Risto A. Kauppinen



Septic diseases associated with the hoof complex: abscesses, punctures wounds, and infection of the lateral cartilage.  


Hoof abscesses are probably the most common cause of acute severe lameness in horses encountered by veterinarians and farriers. Most affected horses show sudden, severe (acute) lameness; the degree of lameness varies from being subtle in the early stages to non-weight bearing. There is still debate between the veterinary and farrier professions as to who should treat a hoof abscess and the best method to resolve the abscess. Puncture wounds to the sole of the foot can introduce bacteria and debris to the solar surface of the distal phalanx and produce a fracture or a septic pedal osteitis. PMID:22981199

Redding, W Rich; O'Grady, Stephen E



Aortic ring abscess and mitral valve aneurysm in aortic valvular endocarditis: enhanced diagnosis with transesophageal echocardiography.  


Aortic ring abscess and mitral valve aneurysms complicating infective endocarditis have previously been described as surgical or autopsy findings. More recently, transesophageal echocardiography has been shown to be more sensitive than standard transthoracic echocardiography or other imaging modalities in detecting each of these complications. Since aortic ring abscess and mitral valve aneurysms virtually mandate surgical intervention, their early detection may be crucial. This report describes a 35-year-old male with congenitally abnormal aortic valve which became infected and in whom both an aortic ring abscess and mitral valve aneurysm occurred. These findings are discussed and the pertinent literature is reviewed. PMID:7889443

Geiger-Dow, J E; Knight, J L; Sanfilippo, A J



Liver abscess and sepsis with Bacillus pantothenticus in an immunocompetent patient: a first case report.  


Bacillus species are aerobic, gram-positive, spore forming rods that are usually found in the soil, dust, streams, and other environmental sources. Except for Bacillus. anthracis (B. anthracis), most species display low virulence, and only rarely cause infections in hosts with weak or damaged immune systems. There are two case reports of B. cereus as a potentially serious bacterial pathogen causing a liver abscess in an immunologically competent patient. We herein report a case of liver abscess and sepsis caused by B. pantothenticus in an immunocompetent patient. Until now, no case of liver abscess due to B. pantothenticus has been reported. PMID:19908347

Na, Jung Sik; Kim, Tae Hyung; Kim, Heung Su; Park, Sang Hyun; Song, Ho Sup; Cha, Sang Woo; Yoon, Hee Jung



A case of Lemierre's syndrome in association with liver abscess without any other metastatic lesions.  


Lemierre's syndrome (LS) is characterized by pharyngitis followed by septicemia, internal jugular vein thrombophlebitis, and metastatic embolization in general. LS is commonly caused by Fusobacterium necrophorum. Herein, we present a case of LS with liver abscesses that presented as a sole metastatic lesion. We were not able to diagnose LS until Fusobacterium necrophorum was isolated due to the lack of the common involvement. Doripenem was effective against the pathologic features including the liver abscesses. LS should be taken into consideration when clinicians find liver abscesses following pharyngitis even when the common complications of LS are not detected. PMID:22687854

Iwasaki, Tomohiro; Yamamoto, Takashi; Inoue, Ken-ichiro; Takaku, Ken-ichi



Gallium-SPECT in the detection of prosthetic valve endocarditis and aortic ring abscess  

SciTech Connect

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.

O'Brien, K.; Barnes, D.; Martin, R.H.; Rae, J.R. (Department of Diagnostic Radiology, Victoria General Hospital Halifax, Nova Scotia (Canada))



Appendicitis and uterine abscess: presentation of an unusual fistula between the gynaecological and gastrointestinal tracts.  


The authors present the case of a 65-year-old woman with clinical and radiological evidence of pelvic sepsis and a medical history of endometrial ablation 20 years previously. She underwent laparotomy after failing to settle with a course of intravenous antibiotics and her appendix was found to have perforated into the uterus with abscess formation which had not discharged vaginally presumably due to widespread intrauterine synechia following her endometrial ablation. She underwent appendectomy and hysterectomy and made a full recovery with no complications. Macroscopic and microscopic examination suggested the appearances are those of an abscess of the uterine fundus with part of the appendix incorporating into the abscess mass. PMID:22984000

Parsons, Sian Ruth; Bennett, Joanne Elizabeth; Kaloo, Philip; Scott, Mike



Focal Intradural Brain Infections in Children: An Analysis of Management and Outcome  

Microsoft Academic Search

Introduction: Focal intradural infections of the brain include empyema and abscess in the supratentorial and infratentorial spaces. These are amenable to surgical management. Various other issues may complicate the course of management, e.g. hydrocephalus with infratentorial lesions or cortical venous thrombosis with supratentorial lesions. Here, we review the management and identify factors affecting outcome in these patients. Materials and Methods:

Venkatesh S. Madhugiri; B. V. Savitr Sastri; Umesh Srikantha; Anirban Deep Banerjee; Sampath Somanna; B. Indira Devi; B. A. Chandramouli; Paritosh Pandey



Percutaneous Management of Abscess and Fistula Following Pancreaticoduodenectomy  

SciTech Connect

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.

AAssar, O. Sami; LaBerge, Jeanne M.; Gordon, Roy L.; Wilson, Mark W.; Mulvihill, Sean J.; Way, Lawrence W.; Kerlan, Robert K. [Department of Radiology, Box 0252, UCSF Medical Center, 505 Parnassus Avenue, San Francisco CA 94143-0252 (United States)



[Pyogenic spinal osteomyelitis with right-sided retroperitoneal abscess].  


A case of osteomyelitis in the lumbar spine in a 66 year old man is reported. On account of high fever and low back pain a focus of infection was searched for in the urinary tracts, in the abdominal cavity and in the hip joint. Not until an abscess in front of the right hip was detected X-ray of the spine was performed and revealed the focus of infection in LII and LIII. After treatment with plaster immobilisation and antibiotics, he recovered completely also as regards neurologic symptoms. However, the stay at hospital lasted six months and the patient was submitted to many investigations including operative procedures before the exact diagnosis and treatment could be carried out. PMID:2781644

Jacobsen, I E



[Indication for surgical therapy of tubo-ovarian abscess].  


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

Moldenhauer, M; Link, H



Molecular analysis of microflora associated with dentoalveolar abscesses.  

PubMed Central

The microflora associated with three dentoalveolar abscesses was determined by cultural and molecular methods. 16S rRNA genes were randomly amplified by means of conserved eubacterial primers and cloned. Restriction fragment length polymorphism analysis of the clones and amplified genes encoding 16S rRNA from the cultured bacteria was used to detect putative unculturable bacteria. Clones representative of five predominant groups of uncultured organisms were sequenced. Two were identified as Porphyromonas gingivalis and Prevotella oris, and one was found to be closely related to Peptostreptococcus micros. The remaining two clones did not correspond to known, previously sequenced organisms. One was related to Zoogloea ramigera, a species of aerobic waterborne organisms, while the other was distantly related to the genus Prevotella. This study has demonstrated the possibility of the characterization of microflora associated with human infection by molecular methods without the inherent biases of culture.

Dymock, D; Weightman, A J; Scully, C; Wade, W G



Multiple Psoas Abscess Formation after Pharmacopuncture -A Case Report-  

PubMed Central

Acupuncture has been widely used in alternative medicine for pain relief but may have many complications due to lack of appropriate cares. Pharmacopuncture is a sort of acupuncture that injects a herbal ingredient through a thin tube for the purpose of combining the effects of the herb and acupuncture and it has many pitfalls. The agents used in pharmacopuncture are not refined for a desired effect and not produced by sterile standard processes under strict medical surveillance. We report a case of a 44-yr-old male patient who had multiple abscesses in the psoas region with fever, right low back and hip pain that began after the pharmacopuncture treatment. This case shows that although pharmacopuncture has been practiced widely, it is important that the appropriate aseptic technique should be used to prevent severe infections and other complications.

Koo, Eun Hye; Chung, Dong Hun; Lee, Il Ok; Kim, Nan Sook; Lim, Sang Ho



[Tuboovarian abscess caused by hydatid cyst: a rare case].  


Primary lesions of hydatid cysts caused by Echinococcus granulosus, are frequently localized in liver, followed by lungs, muscles, kidneys, spleen and bones. Pelvic inoculations are rare and usually occur as a secondary infection. In this report, a case of primary hydatid cyst in the abdomen, spleen and pelvic organs, clinically mimicking tuboovarian abscess, was presented. A nineteen-years-old female patient was admitted to the gynecology outpatient clinic with the complaint of abdominal pain for two days. The case was considered as tuboovarian abscess according to the initial examination findings and hospitalized for treatment and follow-up. In transabdominal ultrasound examination, 44 x 43 mm thin-walled septated cysts in the left ovary and 65 x 65 mm thin-walled multiloculated cysts in the spleen were detected. Abdominal computerized tomography also yielded multivesicular cystic masses in spleen, front abdominal wall and the left ovary. Since the clinical and vital findings worsened, she initially underwent ovarian cystectomy by laparoscopy, then abdominal cystectomy and splenectomy. The operation material examined macroscopically was compatible with hydatid cyst with the characteristics of a germinative membrane and hydatid sand. The diagnosis was confirmed by histopathological examination. The patient was discharged without complication on post-operative sixth day, with a recommendation of albendezol (15 mg/kg/day, 3 months) treatment. Since the patient had undergone emergency surgery, indirect hemaglutination (IHA) test had not been performed pre-operatively. However, post-operative third month serum sample revealed a positive (1/32) IHA titer. In conclusion, hydatid cyst should be kept in mind in the differential diagnosis of patients with abdominal pain, in response to the high prevalence of the parasite in our country. PMID:23621737

Do?an, Keziban; Kaya, Cihan; Karaman, Ulkü; Kalayc?, Mustafa Uygar; Baytekin, Halil F?rat



Complete resolution of a solitary pontine abscess in a patient with dental caries.  


A solitary brainstem abscess is a rare fatal intracranial infection, which can be mistaken for an acute stroke complicated with a systemic infection. Dental caries without abscess formation can be a possible source of infection. Herein, we describe the case of a 59-year-old man with dental caries who presented with a 4-day history of progressive dizziness, double vision, gait ataxia, emesis, and left facial and body numbness. Fever, suboccipital headache, and difficulties in urinating and defecating were noted on admission. Acute brainstem infarction and suspected aspiration pneumonia were then diagnosed. Magnetic resonance spectroscopy and diffusion-weighted imaging demonstrated a solitary pontine abscess. The neurologic deficits continued improvement after he completed 8 weeks of intravenous antibiotics. The successful nonsurgical treatment of the brainstem abscess in this case was based on high clinical suspicion, early diagnosis, and early combination of corticosteroids and broad spectrum antibiotics. PMID:23399347

Chen, Ming-Hua; Kao, Hung-Wen; Cheng, Chun-An



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


Since tuboovarian abscess is almost always a complication of pelvic inflammatory disease, it is rarely observed in virgins. A 30-year-old virgin patient presented with pelvic pain, fever, and vaginal spotting for the previous three weeks. Her abdominopelvic computed tomography scan revealed bilateral multiseptated cystic masses with prominent air-fluid levels suggesting tuboovarian abscesses. The sigmoid colon was lying between two tuboovarian masses, and its borders could not be distinguished from the ovaries. The patient was presumed to have bilateral tuboovarian abscesses which developed as a complication of the sigmoid diverticulitis. She was administered intravenous antibiotic therapy followed by percutaneous drainage under ultrasonographic guidance. She was discharged on the twenty second day with prominent clinical and radiological improvement. Diverticulitis may be a reason for development of tuboovarian abscess in a virgin patient. Early recognition of the condition with percutaneous drainage in addition to antibiotic therapy helps to have an uncomplicated recovery. PMID:22952477

Tuncer, Zafer Selçuk; Boyraz, Gokhan; Yücel, Senem Özge; Selçuk, Ilker; Yazicio?lu, Asl?han



Bartholin's abscess arising within hidradenoma papilliferum of the vulva: a case report  

PubMed Central

Background Hidradenoma papilliferum is an uncommon, benign, cystic, papillary tumor that occurs almost exclusively in the female anogenital region. Bartholin's abscess is also an anogenital cystic lesion caused by obstruction of Bartholin's duct with an overlying infection. Concomitant presentation of Bartholin's abscess and Hidradenoma papilliferum is unique. Case presentation A 43-year-old African American woman presented with a painful cystic mass on the left labia majora. A preoperative diagnosis of Bartholin's abscess was made. During excision and draining, an additional tan-brown dermal nodule was removed which demonstrated histological features of Hidradenoma papilliferum. Conclusion We present what we believe to be the first case of Bartholin's abscess arising in hidradenoma papilliferum and its clinical significance.

Docimo, Salvatore; Shon, Wonwoo; Elkowitz, David E



Detection of a prosthetic aortic valvular abscess with indium-111-labeled leukocytes  

SciTech Connect

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.

Oates, E.; Sarno, R.C.



[A non-abscess-forming inflammation of the corpora cavernosa in a diabetic patient - case report].  


An inflammation of the corpus cavernosum is relatively rare and must be differentiated from a tumour, abscess, thrombosis or embolism of the penile vessels. Most frequently inflammation of the corpus cavernosum is caused by iatrogenic interventions, followed by general infections and acute occlusion of penile vessels. Diabetes mellitus seems to be a predisposing factor. In the case of a 51-year-old diabetic patient with painful induration of the penis, an MR imaging study was undertaken to identify an inflammation of the corpora by exclusion of abscess formation. The inflammation responded well to a two-week oral Fluorchinolon treatment. Due to its high soft-tissue contrast, multiplanar layer images and, the MR scan was performed to identify an inflammation of the corpora cavernosa and to exclude an abscess formation. We consider a therapy with oral antibiotics to be sufficient for a non-abscess-forming cavernitis. PMID:20824577

Rud, O; Mörsler, J; Peter, J; May, M; Gilfrich, C



Localization of abscess in adult polycystic kidney by indium-111 leukocyte scan  

SciTech Connect

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.

Bretan, P.N. Jr.; Price, D.C.; McClure, R.D.



Missed presentation of Crohn's disease in a patient with a fistulating thigh abscess: a case report  

PubMed Central

Background Musculoskeletal presentations of Crohn's disease are rare and they include psoas abscess, thigh abscesses and in extreme cases septic arthropathy. Case presentation Herein, we present a 53 year old gentleman with bilateral thigh fistulae discovered to be a new diagnoses of extra-intestinal Crohn's disease Conclusion It is important to consider Crohn's disease in patients that present with unusual or persistent fistulae and to consider this essential when there are atypical organisms present.



Abscess After a Laparoscopic Appendectomy Presenting as Low Back Pain in a Professional Athlete  

PubMed Central

A professional baseball player presented to the orthopaedic clinic for a preseason assessment because of continued lumbar spine and flank pain. He had a laparoscopic appendectomy for a perforated appendix 8 months before his presentation. He was able to finish the previous season with only mild limitation. He presented with back pain that limited his activity. His examination was nonlocalizing, but subsequent computed tomography revealed a hepatic abscess. The abscess was drained; he was treated with intravenous antibiotics; and his symptoms resolved.

Witkin, Lisa R.; Nguyen, Hien T.; Silberstein, Charles E.; Fayad, Laura M.; McFarland, Edward G.



Sonographic features of intra-abdominal abscess caused by spilled stones during laparoscopic cholecystectomy  

Microsoft Academic Search

Spillage of stones into the abdominal cavity resulting from perforation of the gallbladder is one of the common complications\\u000a of laparoscopic cholecystectomy. Although many surgeons know that stones left in the abdominal cavity can cause late visceral\\u000a abscess requiring surgical treatment, the sonographic features of such abscesses have not yet to be thoroughly investigated.\\u000a We investigated the sonographic features of

Masamichi Matsuda; Goro Watanabe; Masaji Hashimoto; Harushi Udagawa; Chikao Okuda; Kazuo Takeuchi



Pyogenic liver abscess caused by Klebsiella pneumoniae genetic serotype K1 in Japan  

Microsoft Academic Search

Pyogenic liver abscess caused by Klebsiella pneumoniae is an emerging disease worldwide, and we know the serotype K1 strain to be the most virulent strain. We report a Japanese\\u000a case of septic pyogenic liver abscess caused by K. pneumoniae genetic serotype K1. A 60-year old man presented at our hospital in a state of cardiopulmonary arrest. From the patient’s\\u000a chief

Yoshitaka Kohayagawa; Keiko Nakao; Misuzu Ushita; Norio Niino; Masayuki Koshizaki; Yuji Yamamori; Yusuke Tokuyasu; Hiroshi Fukushima



Hyperbaric oxygen therapy in a patient with autosomal dominant polycystic kidney disease with a perinephritic abscess  

Microsoft Academic Search

A 68-year-old female in hemodialysis due to autosomal dominant polycystic kidney disease underwent resection of cysts in her\\u000a right kidney via a laparoscopic approach due to abdominal pain. Three weeks after surgery, she was admitted with sepsis. A\\u000a CT scan showed a large abscess around the right kidney. Percutaneous drainage of abscess was performed. The pus smear showed\\u000a Gram-positive cocci

Jorge Vega; Helmuth Goecke; Francisco Manriquez; Carlos Escobar; Max Escobar; Christian Videla; Mario Santamarina; Carlos Echeverria; Francisco Javier Guarda



Methicillin-resistant Staphylococcus aureus prosthetic aortic valve endocarditis with paravalvular abscess treated with daptomycin.  


Prosthetic valves have been used extensively for severe cardiac valvular dysfunction for the past 3 decades. Prosthetic cardiac valves may be infected with organisms causing bacteremia, particularly gram-positive cocci. Staphylococcus epidermidis (coagulase negative staphylococci) and Staphylococcus aureus , both methicillin-susceptible S. aureus and methicillin-resistant S. aureus (MRSA) strains, are the most frequent pathogens causing prosthetic valve endocarditis (PVE). Vancomycin has been the cornerstone of therapy for serious MRSA infections including bacteremia and endocarditis. Clinicians have noted that MRSA bacteremias treated with vancomycin often fail to clear even with prolonged therapy. Persistent or prolonged MRSA bacteremia unresponsive to vancomycin therapy has led to the treatment of these infections by other agents, that is, quinupristin, dalfopristin, linezolid, or daptomycin. These antibiotics have been found particularly useful in treating MRSA bacteremias unresponsive to vancomycin therapy. We report a case of a patient who presented with MRSA PVE complicated by perivalvular aortic abscess with persistent MRSA bacteremia unresponsive to vancomycin therapy. The patient's MRSA bacteremia was cleared with daptomycin therapy (6 mg/kg/d). Because the patient refused surgery, daptomycin therapy was continued in hopes of curing the endocarditis and sterilizing the perivalvular aortic abscess. Transesophageal echocardiogram revealed a decrease in abscess in the aortic perivalvular abscess after 1 week of daptomycin therapy. The patient made an uneventful recovery. The cure of PVE and perivalvular abscesses usually requires removal of the prosthetic device and abscess drainage. In this case, in which surgery was not an option, medical therapy of PVE and a decrease in size of the aortic perivalvular abscess were accomplished with daptomycin therapy. Daptomycin is an alternative to vancomycin therapy in patients with prolonged or persistent MRSA bacteremia secondary to endocarditis or abscess. PMID:15647736

Mohan, Sowjanya S; McDermott, Brian P; Cunha, Burke A


Subphrenic abscess secondary to Actinomycosis meyeri and Klebsiella ozaenae following laparoscopic cholecystectomy.  


A case is reported of a subphrenic abscess 12 months post-laparoscopic cholecystectomy in a 72-year-old male with identification of Actinomyces meyeri and the oropharyngeal commensal Klebsiella ozaenae. The first organism is exceptionally rare following laparoscopic cholecystectomy and is presumed to be a result of inadvertent gallstone spillage. The second organism has not previously been reported in a subphrenic abscess. The etiopathogenesis and management of this condition are presented. PMID:19487988

Zbar, Andrew P; Ranasinghe, Weranja; Kennedy, Philip J



Sexually transmitted diseases including HIV infection in women with Bartholin's gland abscesses  

Microsoft Academic Search

OBJECTIVES--The aim of this study was to establish the prevalence of sexually transmitted infections including human immunodeficiency virus (HIV) infection in women with Bartholin's gland abscess. SETTING--Gynaecology Clinic of King Edward VIII Hospital, a large urban, referral hospital for the province of Kwa-Zulu Natal, serving an underprivileged population. METHODS--Thirty consecutive women presenting with unruptured Bartholin's gland abscesses were studied. Prior

A A Hoosen; C Nteta; J Moodley; A W Sturm



A case of aseptic abscesses syndrome treated with corticosteroids and TNF-alpha blockade.  


Aseptic abscesses syndrome (AA) is an emerging clinicopathological entity characterized by visceral sterile collections of mature neutrophils that do not respond to antibiotics but regress quickly when treated with corticosteroids. Although most previous case reports of AA have been restricted to Europe, we present here a Japanese woman with AA showing recurrence of splenic abscesses, ileocolitis, pyoderma gangrenosum, and arthritis. Although both steroid therapy and tumor necrosis factor (TNF)-alpha blockade were effective, relapses remained frequent. PMID:22526827

Ito, Tomoyuki; Sato, Naoko; Yamazaki, Hajime; Koike, Tadashi; Emura, Iwao; Saeki, Takako



Successful medical management of intra-abdominal abscesses in 4 adult horses.  


Four adult horses with large intra-abdominal abscesses, suspected to be complications of strangles, were treated with systemic antibiotics alone and made a full recovery. The 100% survival rate is significantly better than other reported survival rates. The median duration of treatment (35 days) was shorter than in most previous reports. This study suggests that penicillin G can be used for successful treatment of strangles associated intra-abdominal abscesses in horses. PMID:23904639

Berlin, Dalia; Kelmer, Gal; Steinman, Amir; Sutton, Gail A



Bacterial subretinal abscess: a case report and review of the literature  

Microsoft Academic Search

PURPOSE: To report a case of Klebsiella subretinal abscess with a successful visual outcome with treatment and to review the literature pertaining to focal intraocular infection in bacterial endophthalmitis.METHODS: Clinical data including medical history, findings on physical examination, blood cultures, and an abdominal computed tomographic scan were collected in a 32-year-old man with Klebsiella sepsis, liver abscesses, and a focal

Eddie W Harris; Donald J D’amico; Robert Bhisitkul; Gregory P Priebe; Robert Petersen



Bilateral psoas abscesses and vertebral osteomyelitis in a patient with sickle cell disease  

PubMed Central

The authors present a case of a patient with sickle-? thalassaemia (S?0 Thal) who had bilateral psoas abscesses on a background of splenectomy in early childhood. The patient also turned out to have vertebral osteomyelitis and hydronephrosis on the side of the larger abscess. The only organism recovered from the patient was a Bacteroides species. The patient was managed with percutaneous drainage and intravenous antibiotics and made a full recovery.

Asnani, M; Williams, E W; Cawich, S; Reid, M; Mansingh, A; Shah, S; Williams-Johnson, Jean



A Case of Staphylococcal Tricuspid Valve Endocarditis With Para-Aortic Abscess in a Patient With Bicuspid Aortic Valve  

PubMed Central

Paravalvular abscess is a serious complication of infective endocarditis. The aortic valve and its adjacent ring are more susceptible to abscess formation and paravalvular extension than the mitral valve. A 15-years old patient with bicuspid aortic valve presented with staphylococcal tricuspid valve endocarditis complicated by para-aortic abscess that ruptured into the aortic sinus. We report the clinical, laboratory and echocardiographic features and treatment of this patient and conduct a literature review on this subject.

Kim, Woo Shin; Kang, Seok Hyung; Lee, Shin A; Ryu, Min Sun



A case of staphylococcal tricuspid valve endocarditis with para-aortic abscess in a patient with bicuspid aortic valve.  


Paravalvular abscess is a serious complication of infective endocarditis. The aortic valve and its adjacent ring are more susceptible to abscess formation and paravalvular extension than the mitral valve. A 15-years old patient with bicuspid aortic valve presented with staphylococcal tricuspid valve endocarditis complicated by para-aortic abscess that ruptured into the aortic sinus. We report the clinical, laboratory and echocardiographic features and treatment of this patient and conduct a literature review on this subject. PMID:21949535

Kim, Woo Shin; Kang, Seok Hyung; Lee, Shin A; Ryu, Min Sun; Park, Seong-Hoon



Mycotic tubo-ovarian abscess associated with the intrauterine device.  


This case report of a 35-year-old white woman, gravida O, may represent the 1st report of tubo-ovarian aspergillosis. The long-term presence of an IUD may have been significant in the etiology. Increasing tenderness and pain in the lower abdomen of 1 week duration was reported. Fever and chills with nausea had been present 12 hours. An increased leukocyte count was found. Other physical findings were normal, except for the presence of a tender pelvic mass. Her last menstrual period had been 2 weeks prior to admission. A Lippes loop had been worn for 11 years and was still present. Intravenous fluids and antibiotics were given. At laparotomy a tuboovarian abscess and peritonitis were found. Multiple cultures were taken. After salpingo-oophorectomy drains were placed within the pelvis and abdomen. Microscopic sections of removed tissue showed compact masses of septate, branching mycelium. Cultures reported pure growth of aspergilli. A 10-day course of amphotericin-B and 5-flurocytosime therapy was given. The patient improved and is being followed as an outpatient. PMID:1266911

Kostelnik, F V; Fremount, H N



Novel use of a radiolabelled antibody against stage specific embryonic antigen for the detection of occult abscesses in mammals  


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.

Thakur, Madhukar L. (Cherry Hill, NJ)



Prevalence and correlates of abscesses among a cohort of injection drug users  

PubMed Central

Recent studies have indicated that injection-related infections such as abscesses and cellulitis account for the majority of emergency room visits and acute hospitalizations accrued by local injection drug users. The objective of this analysis was to examine the prevalence and correlates of developing an abscess among a cohort of injection drug users in Vancouver and to identify socio-demographic and drug use variables associated with abscesses at baseline. We examined abscesses among participants enrolled in a prospective cohort of injection drug users. Categorical variables were analyzed using the Pearson's chi-square test and continuous variables were analyzed using the Wilcoxon signed rank test. Among 1 585 baseline participants, 341 (21.5%) reported having an abscess in the last six months. In a logistic regression model that adjusted for all variables that were associated with having an abscess at p < 0.1 in univariate analyses, female gender [odds ratio (OR) = 1.7, [95%CI: 1.2 – 2.4]; p = 0.002), recent incarceration (OR = 1.7, [95%CI: 1.3 – 2.2]; p < 0.001), sex trade involvement (OR = 1.4 [95% CI: 1.0 – 2.0]; p = 0.03), frequent cocaine use (OR = 1.5 [95%CI: 1.2 – 2.0]; p = 0.002) and HIV serostatus (OR = 1.5, [95%CI: 1.2 – 2.0]; p = 0.003) were positively associated with having an abscess. Explanations for these associations require further study, and interventions are needed to address this highly prevalent concern.

Lloyd-Smith, Elisa; Kerr, Thomas; Hogg, Robert S; Li, Kathy; Montaner, Julio SG; Wood, Evan



Brain Malformations  


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


Surgical treatment of cerebral abscess with the use of a mobile ultralow-field MRI.  


Surgical intervention in cerebral abscess is indicated to confirm diagnosis, to identify pathogens for specific antibiotic therapy, or to reduce mass effect. Regarding long-term outcome, freehand or stereotactic aspiration are equally efficient compared to surgical resection. However, direct observation of relief of mass effect is not possible by either method. Six patients presenting with neurological symptoms and laboratory signs of infection and diagnosed with an intra-axial cystic lesion underwent frameless stereotactic aspiration of a cerebral abscess in our institution with the use of a mobile intraoperative magnetic resonance imaging (MRI) with a field strength of 0.15 T. Images were acquired before and during the procedure and used for neuronavigation. In all six cases, complete evacuation of the abscess with collapse of the cyst could be achieved and documented intraoperatively. No complications were observed. All patients showed clinical improvement postoperatively. We highlight the advantages of using a mobile intraoperative MRI unit with an illustrative case of a patient who had already undergone abscess evacuation without alleviation of symptoms before using intraoperative MRI. Finally, we discuss surgical treatment options of cerebral abscesses. PMID:18836754

Senft, Christian; Seifert, Volker; Hermann, Elvis; Gasser, Thomas



Transurethral resection of prostate abscess: is it different from conventional transurethral resection for benign prostatic hyperplasia?  


Purpose. To present our experience of prostate abscess management by modified transurethral resection (TUR) technique. Methods. Seventeen men with prostate abscess undergoing TUR between 2003 and 2011 were retrospectively analyzed. Details of demography, surgical procedures, complications, and followup were noted. Results. With a mean age of 61.53 ± 8.58 years, all patients had multifocal abscess cavities. Initially, 6 men underwent classical TUR similar to the technique used for benign prostatic enlargement (group 1). Next, 11 men underwent modified TUR (group 2) in which bladder neck and anterior zone were not resected. The abscess cavities resolved completely, and no patient required a second intervention. One patient in group 1 and three in group 2 had postoperative fever requiring parenteral antibiotics (P = 0.916). Three patients in group 1 had transient urinary incontinence, whereas none of the patients in group 2 had this complication (P = 0.055). Four and five men in group 1 and 2 reported retrograde ejaculation, respectively (P = 0.740). Conclusion. The modified technique of prostate resection edges over conventional TURP in the form of reduced morbidity but maintains its high success rate for complete abscess drainage. It alleviates the need for secondary procedures, having an apparent advantage over limited drainage techniques. Use of this technique is emphasized in cases associated with BPH and lack of proper preoperative imaging. PMID:23840969

Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan; Dalela, Divakar



[Surgical therapy of acute endocarditis of the aortic valve with paravalvular abscess. 7 years experiences].  


Operative treatment of acute valve endocarditis with paravalvular abscess remains a surgical challenge. The aim of the study was gaining insights into the influence of our surgical strategy on the short- and midterm results. Over a period of 7 years 18 patients underwent surgical treatment of a paravalvular abscess accompanying their acute aortic valve endocarditis. All patients ranged preoperative in the NYHA class IV. Eleven patients suffered from native and 7 from prosthetic aortic valve endocarditis. Staphylococcus aureus was found to have caused the infection in 50% of the cases. Surgical therapy consisted in all patients of thorough resection of the infected tissue followed by reconstruction of the defect with the aid of autologus pericardial patch and replacement of the aortic valve using a prosthesis. Although the rate of complications continued high early lethality remained at 5.5%. Midterm results proved to be very good with a follow-up of 44 month. Both lethality and the reoperation rate stayed at 0%. The operative risk of acute aortic valve endocarditis with paravalvular abscess is high but acceptable. Should a paravalvular abscess be diagnosed during a case of endocarditis urgent surgical therapy is highly advisable even there is only a minor deterioration of the patient' clinical state. Radical abscess debridement in combination with exclusion of the place of resection from circulation using an autologus pericard patch is a necessary condition for achieving good results. PMID:12836457

Vicol, Calin; Barth, Gert



Microbiology of cysts/abscesses of Bartholin's gland: review of empirical antibiotic therapy against microbial culture.  


Bartholin's glands are prone to obstruction at their opening into the vestibule, forming cysts which could be infected to become gland abscess. In our unit, treatment of Bartholin's abscess is usually surgical. In addition to surgical treatment, antimicrobial agents are often administered before microbial culture results are known. In this study, we aimed to determine the most common pathogens in Bartholin's glands abscess in our local population so that empiric antimicrobial therapy, if required, could be correctly directed. Among the 78 cases reviewed, there was positive microbial culture in 73.9%. Bartholin's abscess was commonly caused by opportunistic organisms, either as single agents or polymicrobial infections. Aerobic organisms were the commonest with coliforms being the most common bacteria. No cases of N. gonorrhoea or C. trachomatis were encountered. Flucloxacillin as a single agent was the most frequently prescribed antibiotic. Poly-pharmacy was common practice. It was concluded that whether adjuvant antibiotic therapy is necessary following surgical treatment of Bartholin's abscess is still controversial. Where antibiotics are required, the optimal initial therapy is not known. As poly-microbial infections are common, a broad spectrum agent like co-amoxiclav may be suitable for empirical treatment until culture results are known. PMID:20925614

Bhide, A; Nama, V; Patel, S; Kalu, E



Clinical Manifestations and Prognostic Factor of Iliopsoas Abscess  

PubMed Central

Introduction: Iliopsoas abscess (IPA) is a collection of pus in the iliopsoas compartment, which is considered rare in Japan. However, the number of patients with IPA has recently increased among the elderly or compromised hosts. Subjects and Methods: This retrospective study aims to examine the clinical pictures, pathological findings, and the prognostic factor of IPA. We analyzed all patients with IPA who were admitted to our hospital from April 2006 to July 2011. Patients’ characteristics, treatment, clinical outcome, radiological findings, bacteria isolated, and comorbidities were evaluated. The comorbidities were evaluated by the Charlson comorbidity index (CCI). We compared the survival and non-survival groups to assess the prognostic factors of IPA. Results: A total of 33 patients were enrolled in this study, which included 14 males and 19 females. The mean age of the patients was 71.5 years (range 32-92 years). The most common underlying disease was spinal disease (16 of 33, 48.5%). Twenty-nine patients (87.9%) were cured and four patients (12.1%) died. While 12 patients (36.4%) were initially treated conservatively with antibiotics alone, percutaneous drainage was performed initially in 19 patients (57.6%). Two patients (6%) directly underwent exploratory surgery and open drainage. In terms of patients’ characteristics, there were no significant differences in either group. The score of CCI in non-survivors was higher than that in survivors (1.38 vs. 5.5, P < 0.001). Conclusions: The epidemiology of IPA is quite different from what it used to be. CCI appears to be useful in evaluating the patients’ prognosis with IPA.

Asai, Nobuhiro; Ohkuni, Yoshihiro; Yamazaki, Ikuo; Kawamura, Yasutaka; Kaneko, Norihiro; Aoshima, Masahiro



Serum ferritin in Nigerian patients with amoebic liver abscess and other tropical infections with liver involvement.  


Serum ferritin was measured by immunoradiometric assay in 46 Nigerian patients with amoebic liver abscess and other tropical infections involving the liver, and the values were compared with those in 23 control subjects. Serum ferritin was markedly elevated in 100% of the patients with amoebic liver abscess, acute viral hepatitis and liver tuberculosis. Elevated values were observed in about 77% of patients with cirrhosis, 80% of malaria patients, and only about 30% of patients with early infection of schistosomiasis mansoni. The results support previous data indicating that significant changes in serum ferritin occur in acute and chronic liver disease. Assay of serum ferritin may be a useful complimentary liver function test for the diagnosis and monitoring the treatment provided in amoebic liver abscess. PMID:6136177

Bolarin, D M



Perihepatic abscess secondary to retained appendicolith: A rare complication managed laparoscopically  

PubMed Central

Appendicectomy is one of the commonest emergency operations performed worldwide. In cases of perforated appendicitis, the prevalence of post-operative abscess formation is up to 20 per cent (1). Most cases can be managed with drainage and antibiotics. However, a minority of these will leave a retained appendicolith. We present a case of a 17 year old female patient who presented 1 year after laparoscopic appendicectomy for perforated appendicitis, with right upper quadrant pain and sepsis. Computed tomography (CT) of the abdomen was performed and revealed a retained appendicolith with perihepatic abscess formation in the right upper quadrant. She underwent laparoscopic drainage of this perihepatic abscess and removal of the faecolith. She was discharged home the following day and remains well.

Maatouk, Mohamed; Bunni, John; Schuijtvlot, Marjolijn



Scedosporium apiospermum endophthalmitis: diffusion-weighted imaging in detecting subchoroidal abscess  

PubMed Central

Purpose To describe the imaging appearance of Scedosporium apiospermum (S. apiosermum) endophthalmitis in an immunocompetent female who underwent high resolution magnetic resonance imaging (MRI) of the orbits and showed subchoroidal abscess on diffusion-weighted imaging. Methods We highlight utility of MRI sequences: diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), fluid-attenuated inversion recovery (FLAIR), and contrast-enhanced magnetic resonance imaging (CE-MRI) in the detection of a subchoroidal abscess and characterization of the inflammatory change of the uveal tract. Vitreous culture grew S. apiospermum. Conclusion Fungal endophthalmitis is a rare but aggressive process. Clinically, it can mimic other disease entities such as neoplasm. To the best of our knowledge, this is the first case that describes the CT and MRI imaging findings of S. apiospermum endophthalmitis. We emphasize the use of DWI and ADC sequences in the detection of subchoroidal abscess.

Bhuta, Sandeep; Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi



Failure of omasal transport attributable to perireticular abscess formation in cattle: 29 cases (1980-1986).  


During a 7-year period, failure of omasal transport attributable to a perireticular abscess was diagnosed in 29 cows. Affected cattle were examined because of anorexia, hypogalactia, and bilateral abdominal distention. The cows were all female Holsteins, 15 months to 10 years old. The abscess was identified during exploratory celiotomy and rumenotomy or at necropsy. Traumatic reticuloperitonitis was believed to be the cause. Twenty-seven cattle (93%) were treated surgically. The abscess was drained into the reticulum or omasum in 25 cows (86%). Twenty-four cows (83%) survived to the time of discharge from the hospital, and 20 (69%) survived for at least 1 year and became productive members of the herd. This is a better survival rate than that reported for other causes of vagal indigestion. PMID:2925501

Fubini, S L; Ducharme, N G; Erb, H N; Smith, D F; Rebhun, W C



Acute and serious myositis with abscess in thigh muscle after transobturator tape implantation.  


The complications of transobturator tape (TOT) were known as lower urinary tract injury, postoperative urinary retention, urge incontinence, vaginal erosion, and etc. A 63-year-old woman presented with new onset of severe pain, heating, and swelling of the left thigh and perineum. She had undergone TOT implantation for stress urinary incontinence (SUI) 4 days previously in an outside clinic. Painful left thigh swelling and skin erythema were noted on the physical examination. A computed tomography (CT) scan showed multiple, large left medial thigh and obturator abscesses. Removal of the implanted tape and abscess drainage were performed immediately and two additional operations were needed for proper abscess drainage. We believe this case to be one of the most serious complications to occur since the introduction of the TOT procedure. Here we report this case and discuss its initial management along with a review of the literature. PMID:21179337

Kim, Young Won; Kim, Sung Min; Kim, Won Tae; Kim, Yong June; Yun, Seok Joong; Lee, Sang Cheol; Kim, Wun Jae



Multimodality imaging of the mitral paravalvular abscess cavity with left ventriculo-atrial fistula.  


Paravalvular complications may occur in patients with infective endocarditis. Paravalvular abscess formation rarely occurs and if so it generally involves the aortic valve. Herein we present a case of left ventriculo-atrial fistula formation through mitral paravalvular abscess cavity shown by multimodality imaging including two- and real-time three-dimensional transoesophageal echocardiography (RT 3-D TEE), cardiac magnetic resonance imaging (CMRI), multislice computed tomography (MSCT) and ventriculography in a patient with a mechanical prosthetic mitral valve. This is the first case in the literature of a mechanical prosthetic mitral valve complicated by a left ventriculo-atrial fistula formation in a healed abscess cavity that is demonstrated with RT-3D TEE, cardiac MRI and MSCT. PMID:22476021

Gürsoy, Mustafa Ozan; Özkan, Mehmet; Aykan, Ahmet Ça?r?; Y?ld?z, Mustafa; Kahveci, Gökhan



Dysphagia due to Retropharyngeal Abscess that Incidentally Detected in Subarachnoid Hemorrhage Patient  

PubMed Central

Cerebral hemorrhage is one of the most common causes of dysphagia. In many cases, dysphagia gets better once the acute phase has passed. Structural lesions such as thyromegaly, cervical hyperostosis, congenital web, Zenker's diverticulum, neoplasm, radiation fibrosis, and retropharyngeal abscess must be considered as other causes of dysphagia as well. Retropharyngeal abscess seldom occur in adults and if it does so, a search for a prior dental procedure, trauma, head and neck infection is needed. The symptoms may include neck pain, dysphagia, sore throat, and in rare cases, dyspnea accompanied by stridor. We present a case and discuss a patient who had dysphagia and neck pain after a cerebral hemorrhage. Testing revealed a retropharyngeal abscess. The symptoms were successfully treated after the administration of antibiotics.

Lee, Jung Hwan; Kwon, Bum Sun; Ryu, Ki Hyung; Lee, Ho Jun; Park, Young Geun; Chang, Ji Hea; Sim, Kyoung Bo



Recovery after tetraplegia caused by dermal sinus infection: intramedullary abscess and tetraparesis.  


Congenital dermal sinuses result from abnormal neurulation, and are uncommon. A spinal intramedullary abscess secondary to an infected dermoid cyst is very rare, and the functional prognosis is usually quite poor. We report on a 16-month-old child with tetraplegia secondary to intramedullary abscesses because of a dermoid cyst infection associated with a dermal sinus. The abscesses were drained, and the dermoid cyst was removed. Antibiotics were administered for 6 weeks after neurosurgery. The child was followed at a pediatric rehabilitation department. After 1 year, he was able to walk quickly and had regained appropriate upper limb motor function for his age. However, bladder sphincter dyssynergia persisted, requiring intermittent catheterization. This case highlights the importance of early diagnosis for surgical intervention and prolonged antibiotic therapy. Long-term follow-up by a multidisciplinary team allowed for the effective management of related neurologic, orthopedic, and bladder disorders. PMID:21310342

Houx, Laetitia; Brochard, Sylvain; Peudenier, Sylviane; Dam Hieu, Phong; Rémy-Néris, Olivier



Septic pulmonary embolism associated with a peri-proctal abscess in an immunocompetent host.  


Septic pulmonary embolism is an uncommon disease in which septic thrombi are mobilised from an infectious nidus and transported in the vascular system of the lungs. It is usually associated with tricuspid valve vegetation, septic thrombophlebitis or infected venous catheters. We report an immunocompetent young man who presented with fever and pleuritic chest pain. Chest roentgenography and CT showed multiple ill-defined nodules, with central cavitation and feeding vessels. He was found to have a clinically infectious source of methicillin-resistant staphylococcus aureus (MRSA) cultured from the peri-proctal abscess with the same bacteraemia. Pulmonary septic embolism from peri-proctal abscess was diagnosed by image study and bacterial culture correlation. All of the clinical presentations improved after the incision of the peri-proctal abscess and anti-MRSA antibiotics treatment. PMID:21686732

Chang, Enting; Lee, Kuo-Hsien; Yang, Kuang-Yao; Lee, Yu-Chin; Perng, Reury-Perng



Aortic annular abscess complicating prosthetic valve endocarditis with group G streptococcus: detection during life with transesophageal echocardiography.  


Infection with group G streptococcus is an unusual but virulent cause of endocarditis. Aortitis and abscess formation due to this organism have been described in one previous report, but only at necropsy. We present here a patient with group G streptococcal endocarditis and aortic annular abscess diagnosed during life by transesophageal echocardiography, leading to successful surgical intervention. PMID:8269167

Pollack, B D; Belkin, R N; Rubin, D A; Moggio, R A



Neutrophils Play a Critical Role in Early Resistance to Amebic Liver Abscesses in Severe Combined Immunodeficient Mice  

Microsoft Academic Search

Animal models of liver abscess formation with Entamoeba histolytica suggest that the neutrophil is the first cell of the host immune system to interact with the invading ameba. In vitro studies have suggested that lysis of neutrophils by virulent amebae may exacerbate the damage seen in amebic liver abscesses. To investigate the role of neutrophils in vivo, we used the




Percutaneous Transhepatic Drainage of Inaccessible Abdominal Abscesses Following Abdominal Surgery Under Real-Time CT-Fluoroscopic Guidance  

SciTech Connect

This study evaluated the safety, feasibility, and clinical utility of transhepatic drainage of inaccessible abdominal abscesses retrospectively under real-time computed tomographic (CT) guidance. For abdominal abscesses, 12 consecutive patients received percutaneous transhepatic drainage. Abscesses were considered inaccessible using the usual access route because they were surrounded by the liver and other organs. The maximum diameters of abscesses were 4.6-9.5 cm (mean, 6.7 {+-} 1.4 cm). An 8-Fr catheter was advanced into the abscess cavity through the liver parenchyma using real-time CT fluoroscopic guidance. Safety, feasibility, procedure time, and clinical utility were evaluated. Drainage catheters were placed with no complications in abscess cavities through the liver parenchyma in all patients. The mean procedure time was 18.8 {+-} 9.2 min (range, 12-41 min). All abscesses were drained. They shrank immediately after catheter placement. In conclusions, this transhepatic approach under real-time CT fluoroscopic guidance is a safe, feasible, and useful technique for use of drainage of inaccessible abdominal abscesses.

Yamakado, Koichiro, E-mail:; Takaki, Haruyuki; Nakatsuka, Atsuhiro; Kashima, Masataka; Uraki, Junji; Yamanaka, Takashi; Takeda, Kan [Japan Mie University School of Medicine, Department of Radiology (Japan)



The effect of zinc on microbial growth and bacterial killing by cefazolin in a Staphylococcus aureus abscess milieu.  


Microbial growth and antimicrobial bacterial killing are both diminished in abscesses. It was postulated that zinc depletion in abscesses, perhaps secondary to a neutrophil protein resembling calprotectin, may be partly responsible for these effects. In a rabbit tissue-cage abscess model, pooled abscess supernatant concentration of zinc was < 1.53 microM. The addition of 41.7 microM zinc had no effect on Staphylococcus aureus growth or the bacterial killing effect of cefazolin in serum. In abscess fluid supernatants, bacterial growth without antibiotic and bacterial killing by cefazolin were both enhanced by the addition of zinc. Fractionation of the abscess fluid with ultrafiltration membranes showed that these effects could be reproduced with the fraction between 30 and 50 kDa. These findings suggest that a protein in abscess fluid supernatants that resembles the neutrophil protein calprotectin may, through its zinc binding effects, inhibit microbial growth within an abscess but also inhibit the activity of bactericidal antibiotics. PMID:8376834

Bamberger, D M; Herndon, B L; Suvarna, P R



Abscess of adrenal gland caused by disseminated subacute Nocardia farcinica pneumonia. A case report and mini-review of the literature  

PubMed Central

Background Infections caused by Nocardia farcinica are uncommon and show a great variety of clinical manifestations in immunocompetent and immunocompromised patients. Because of its unspecific symptoms and tendency to disseminate it may mimic the clinical symptoms and radiologic findings of a tumour disease and the diagnosis of nocardiosis can easily be missed, because there are no characteristic symptoms. Case presentation We present a case of an adrenal gland abscess caused by subacute disseminated N. farcinica pneumonia. Conclusion An infection with N. farcinica is potentially lethal because of its tendency to disseminate -particularly in the brain- and its high resistance to antibiotics. Awareness of this differential diagnosis allows early and appropriate treatment to be administered.



Acute abscess with fistula: long-term results justify drainage and fistulotomy.  


Conventional treatment of anal abscess by a simple drainage continues to be routine in many centers despite retrospective and randomized data showing that primary fistulotomy at the time of abscess drainage is safe and efficient. The purpose of this study is to report the long-term results of fistulotomy in the treatment of anal abscesses. This is a prospective nonrandomized study of 165 consecutive patients treated for anal abscess in University Hospital Hassan II, Fez, Morocco, between January 2005 and December 2010. Altogether 102 patients were eligible to be included in the study. Among them, 52 were treated by a simple drainage and 50 by drainage with fistulotomy. The results were analyzed in terms of recurrence and incontinence after a median follow-up of 3.2 years (range 2-6 years). The groups were comparable in terms of age, gender distribution, type and size of abscess. The recurrence rate after surgery was significantly higher in the group treated by drainage alone (88 %) compared to other group treated by drainage and fistulotomy (4, 8 %) (p < 0.0001). However, there was a tendency to a higher risk of fecal incontinence in the fistulotomy group (5 % vs 1 %), although this difference was not significant (p = 0.27). In the group treated by drainage and fistulotomy, high fistula tract patients are more prone to develop incontinence and recurrence, mainly within the first year. A long-term follow-up seems not to influence the results of fistulotomy group. These findings confirm that fistulotomy is an efficient and safe treatment of anal abscess with good long-term results. An exception is a high fistula, where fistulotomy may be associated with a risk of recurrence and incontinence. PMID:23784672

Benjelloun, E B; Jarrar, A; El Rhazi, K; Souiki, T; Ousadden, A; Ait Taleb, K



Health and Economic Burden of Post-Partum Staphylococcus aureus Breast Abscess  

PubMed Central

Objectives To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess. Study design We conducted a matched cohort study (N?=?216) in a population of pregnant women (N?=?32,770) who delivered at our center during the study period from 10/1/03–9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates. Results Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%), milk fistula (11.1%) and hospital readmission (50%) occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340–$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. –susceptible S. aureus cases. Conclusions Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections.

Branch-Elliman, Westyn; Lee, Grace M.; Golen, Toni H.; Gold, Howard S.; Baldini, Linda M.; Wright, Sharon B.



[Psoas major abscess by heroin addictive patients--a case report].  


Drug abuse is related to many medical complications, which depend on the drug type, dose injected, the method of delivery and site of injection. We report a case of psoas abscess in young heroin addict, HIV negative, who was admitted in Emergency Center of Clinical Center in Belgrade because of fever, anaemia, prostration and right groin pain. Clinical and radiological examination were performed. CT showed large abscess of the right psoas muscle, 12 x 4 cm large. Treatment included percutaneous drainage and administration of iv antibiotics. There is regression of inflamation. At discharge patient was in good condition without signs of infection. PMID:22369030

Bumbasirevi?, Marko Z; Zagorac, Slavisa G; Lesi?, Aleksandar R; Bumbasirevic, Vesna; Durasi?, Ljubomir M



Emergency department diagnosis of a quadriceps intramuscular loculated abscess/pyomyositis using dynamic compression bedside ultrasonography  

PubMed Central

Introduction A 73-year-old man with a past medical history of myelodysplastic syndrome and recent chemotherapy presented to the emergency department with a 1-week history of progressively increasing left thigh pain and swelling. His physical examination revealed left anterolateral diffuse thigh swelling with no erythema or warmth to palpation. The anterolateral quadriceps was markedly tender to palpation. Emergency department bedside dynamic compression ultrasonography that was performed on the left anterolateral thigh revealed a quadriceps intramuscular abscess with loculated yet movable pus. Conclusion Bedside dynamic compression ultrasonography can assist the emergency or critical care physician in the diagnosis of quadriceps intramuscular abscess or pyomyositis.



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

PubMed Central

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

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



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

SciTech Connect

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

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



Absceso bacteriano labial en paciente inmunocompetente [Bacterial lip abscess in an immunocompetent patient].  


Lip abscesses are a potentially serious condition rarely reported in the medical literature. This disease requires prompt diagnosis and treatment with hospitalization, intravenous antibiotics, and urgent surgical drainage. Clinical knowledge of this condition is essential to guide the differential diagnosis and correctly adapt the etiological treatment. The presence of necrotic and cavitated lesions requires ruling out immunosupression or methicillin-resistant agent. We report a necrotic and cavitated bacterial lip abscess caused by methicillin-sensitive Staphylococcus aureus in an immunocompetent male. PMID:24021372

Godoy-Gijón, Elena; Pozo-de Dios, Juan Carlos Del; Román-Curto, Concepción



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

PubMed Central

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

Liang, Hui; Liu, Ou-Qi; Ai, Xin-Bo; Zhu, Da-Qi; Liu, Jin-Lan; Wang, An; Gong, Fei-Yue; Hu, Cong



Splenic abscess caused by Salmonella braenderup, treated with percutaneous drainage and antibiotics.  


Splenic abscess is a rare condition and its optimal treatment is still debated. We report on a 17-year-old immunocompetent female patient, hospitalized with Salmonella braenderup gastroenteritis and splenic abscess, who was treated with ciprofloxacin, percutaneous catheter drainage and despite remaining drainage of 50 ml/24 h, the catheter was removed and the antibiotic treatment was stopped when the fluid was clear. Following removal a transient increase in the size of the splenic cavity was observed, but without any clinical symptoms or deterioration of laboratory parameters. At the 1-year follow-up, ultrasound examination of the spleen disclosed only a 8 mm scar. PMID:9360262

Rřrbakken, G; Schulz, T



Legionellosis and Lung Abscesses: Contribution of Legionella Quantitative Real-Time PCR to an Adapted Followup  

PubMed Central

We report a case of severe Legionnaires' disease (LD) complicated by a lung abscess in an immunocompetent patient who required ECMO therapy and thoracic surgery. The results of repeated Legionella quantitative real-time PCR performed on both sera and respiratory samples correlated with the LD severity and the poor clinical outcome. Moreover, the PCR allowed for the detection of Legionella DNA in the lung abscess specimen, which was negative when cultured for Legionella. This case report provides a logical basis for further investigations to examine whether the Legionella quantitative PCR could improve the assessment of LD severity and constitute a prognostic marker.

Descours, G.; Tellini, C.; Flamens, C.; Philit, F.; Celard, M.; Etienne, J.; Lina, G.; Jarraud, S.



Successful switch to oral therapy with doxycycline in the case of an actinomycotic hepatic abscess.  


A 72-year-old female was admitted with the symptoms of malaise, loss of appetite, upper right quadrant pain, fever, and sweats, which had been present for last 7 days. CT-scan of the abdomen revealed a hypodense mass in the right liver lobe; histopathological examination of the biopsy specimen yielded a diagnosis of actinomycotic abscess. Treatment with intravenous ampicillin for 8 weeks followed by a course of oral doxicycline for 28 weeks resulted in the complete resolution of the abscess. PMID:23669433

Petrache, Diana; Popescu, Gabriel-Adrian



Perforation of Meckel's Diverticulum by a Peanut Presenting as a Mesentery Abscess  

PubMed Central

Background Perforation of Meckel's diverticulum by a foreign body in children is rarely reported and is usually associated with localized or generalized fibropurulent peritonitis. Case Presentation The authors encountered such a case in a 4-year-old boy with perforation of Meckel's diverticulum by a piece of peanut presenting as a mesentery