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Sample records for gas-forming brain abscess

  1. Brain abscess

    MedlinePlus

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

  2. Brain abscess: Current management

    PubMed Central

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

    2013-01-01

    Brain abscess (BA) is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA. PMID:24174804

  3. Hematogenous Pasteurella multocida brain abscess

    SciTech Connect

    Wallace, M.; Lipsky, B.A.

    1985-10-01

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

  4. Amebic abscess of the brain.

    PubMed

    Becker, G L; Knep, S; Lance, K P; Kaufman, L

    1980-02-01

    Brain abscesses caused by Entamoeba histolytica were treated in two residents of New Jersey, neither of whom had traveled beyond the eastern United States. The diagnosis in Case 1 was confirmed by the presence of ameba in both brain and pituitary abscesses. An elevated indirect hemagglutination (IHA) titer of 1:4096 and response to specific treatment with metronidazole and chloroquin were the criteria for diagnosis in Case 2. The computerized tomographic appearance of an amebic abscess is that of a rapidly progressive lesion without reaction in the adjacent brain. Of the seven reported cures, all of the patients received appropriate chemotherapy. Five of the seven were operated upon. PMID:6245387

  5. Experimental Staphylococcus aureus brain abscess.

    PubMed

    Enzmann, D R; Britt, R R; Obana, W G; Stuart, J; Murphy-Irwin, K

    1986-01-01

    The virulent organism Staphylococcus aureus produced brain abscesses that were quantitatively and qualitatively different from those caused by less virulent organisms. S. aureus abscesses created larger lesions, as earlier ependymitis, delayed progress toward healing, and caused areas of inflammatory escape outside the collagen capsule. Imaging tests revealed similar findings: the abscesses were larger, had more extensive central necrosis, and showed earlier evidence of ependymitis. This virulent organism also demonstrated that white matter is more susceptible than overlying gray matter to destruction by infection. The pattern of spread and other histologic findings suggest that collagen capsule formation has less of an infection "containment" function than was previously thought. PMID:3085444

  6. Actinomyces meyeri brain abscess following dental extraction.

    PubMed

    Clancy, U; Ronayne, A; Prentice, M B; Jackson, A

    2015-04-13

    We describe the rare occurrence of an Actinomyces meyeri cerebral abscess in a 55-year-old woman following a dental extraction. This patient presented with a 2-day history of hemisensory loss, hyper-reflexia and retro-orbital headache, 7 days following a dental extraction for apical peridonitis. Neuroimaging showed a large left parietal abscess with surrounding empyema. The patient underwent craniotomy and drainage of the abscess. A. meyeri was cultured. Actinomycosis is a rare cause of cerebral abscess. The A. meyeri subtype is particularly rare, accounting for less than 1% of specimens. This case describes an unusually brief course of the disease, which is usually insidious. Parietal lobe involvement is unusual as cerebral abscesses usually have a predilection for the frontal and temporal regions of the brain. Although there are no randomised trials to guide therapy, current consensus is to use a prolonged course of intravenous antibiotics, followed by 6-12 months of oral therapy.

  7. A Pneumococcal Brain Abscess: A Case Report

    PubMed Central

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

    2013-01-01

    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. PMID:24086878

  8. Brain abscess caused by Nocardia asiatica

    PubMed Central

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

    2016-01-01

    Background: Nocardia infection of the central nervous system leading to brain abscess is a rare condition but has a high mortality rate. Among the species of Nocardia, only three cases of brain abscess due to Nocardia asiatica infection have been reported. Case Description: A 65-year-old man with a history of autoimmune hemolytic anemia treated with prednisolone presented to our hospital because of occipital headache. Brain magnetic resonance imaging showed bilateral occipital lesions. The patient underwent craniotomy and resection of the left occipital lobe lesion. N. asiatica was identified by 16S rRNA sequencing of the resected specimen. Treatment with trimethoprim/sulfamethoxazole led to a complete resolution of the brain lesion. Conclusion: Because of the different antimicrobial sensitivity patterns among Nocardia species, both appropriate subtyping and susceptibility testing of uncommon species such as N. asiatica are required for the successful treatment of nocardial infections. PMID:27563485

  9. Four cases of nocardial brain abscess

    PubMed Central

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

    2012-01-01

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

  10. Brain abscess due to Haemophilus aphrophilus: case report

    PubMed Central

    Yamashita, J.; Bone, F. J.; Hitchcock, Edward

    1972-01-01

    A temporal lobe abscess due to H. aphrophilus occurred in a child of 11 years, and was successfully treated by aspiration, chemotherapy, and excision of the abscess wall. The organism is an unusual cause of brain abscess and this is believed to be the first reported case in Britain. PMID:4647862

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

    PubMed

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

    2013-03-01

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

  12. Management and outcome of brain abscess in renal transplant recipients

    PubMed Central

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

    2000-01-01

    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 PMID:10727562

  13. A case series of brain abscesses in Malawian children.

    PubMed

    Mankhambo, L; Phiri, A; Chiwaya, K; Waluza, J; Borgstein, Es; Graham, Sm

    2007-09-01

    We report three cases of brain abscess in children admitted to QECH in 2006. All children were HIV-uninfected. One case was associated with staphylococcal empyema, another with chronic suppurative otitis media and mastoiditis, and the third case had no identified extracranial focus of infection. These cases illustrate the difficulties of diagnosis and management of brain abscesses in the resource-poor setting where other causes of infection of the central nervous system are common. The typical clinical presentation of brain abscess of altered mental state and seizures is also characteristic of cerebral malaria and meningitis and it is likely that many cases of brain abscess in Malawian children are not diagnosed. The value of cranial CT scan, ideally with contrast, for diagnosis and management of brain abscess is highlighted by these cases.

  14. Successful Treatment of Multifoci Nocardial Brain Abscesses

    PubMed Central

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

    2015-01-01

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

  15. Brain abscess as a manifestation of spinal dermal sinus

    PubMed Central

    Emami-Naeini, Parisa; Mahdavi, Ali; Ahmadi, Hamed; Baradaran, Nima; Nejat, Farideh

    2008-01-01

    Dermal sinuses have been associated with a wide spectrum of clinical manifestations ranging from asymptomatic to drainage of purulent material from the sinus tract, inclusion tumors, meningitis, and spinal abscess. To date, there has been no documented report of brain abscess as a complication of spinal dermal sinus. Here, we report an 8-month-old girl who was presented initially with a brain abscess at early infancy but lumbar dermal sinus and associated spinal abscess were discovered afterwards. The probable mechanisms of this rare association have been discussed. PMID:19209295

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

    PubMed

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

    2015-04-01

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

  17. Brain Abscesses of Ear, Nose, and Throat Origin

    PubMed Central

    Couloigner, Vincent; Sterkers, Olivier; Redondo, Aimée; Rey, Alain

    1998-01-01

    This retrospective study analyzed 29 cerebral abscesses of ear, nose, and throat (ENT) origin. The mean follow-up of patients was 37 months. ENT etiologies included 45% otitis media (n = 13), 48% sinusitis (n = 14), and 7% ethmoidal sinus tumors (n = 2). Thirty-eight percent (n = 5) of otogenic abscesses occurred within 15 days after a mastoidectomy. Sinogenic abscesses were never due to surgery but were associated in 31% of cases (n = 5) with anterior skull base defects. The main locations of otogenic abscesses were the temporal lobe (54%; n = 7) and the cerebellum (23%; n = 3), whereas sinogenic abscesses were located in the frontal lobe in 75% of cases (n = 12). Because of this location, sinogenic abscesses were less symptomatic than otogenic ones and had greater size and encapsulation at the time of diagnosis. Thus, they required longer antibiotic treatment (p = 0.05) and more numerous surgical drainages (p = 0.02). Bacteriologic abscesses samples were positive in 90% of cases. Bacteria found in brain abscesses were different from the ones found in ENT samples in 62% of cases. Thus, the results of ENT bacteriologic samples were not helpful for choosing adequate antibiotic agents in case of negative brain abscess samples. Although mortality was not significantly higher in otogenic abscesses (31%; n = 4) than in sinogenic ones (6%; n = 1, p = 0.08), otogenic abscesses appeared more threatening. Indeed, they represented 80% (n = 4) of lethal cases and encompassed more clinical or radiological prognosis pejorative factors than sinogenic ones (p = 0.006). In conclusion, higher danger of otogenic abscesses mainly resulted both from their temporal or cerebellous locations and from the bacteria that were more frequently resistant to antibiotics. PMID:17171060

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

    PubMed

    Simpson, Donald

    2013-12-01

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

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

    PubMed

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

    2012-10-01

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

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

    PubMed

    Simpson, Donald

    2013-12-01

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

  1. Brain abscesses in Malawian children: value of CT scan.

    PubMed

    Mankhambo, L; Phiri, A; Chiwaya, K; Graham, S M

    2008-03-01

    The clinical presentation and management of brain abscess in three HIV-uninfected Malawian children are reported. One case was associated with staphylococcal empyema and severe malarial anaemia and another case with chronic suppurative otitis media and mastoiditis. The third case had no identified extracranial focus of infection. These cases illustrate the difficulties of diagnosis and management of brain abscesses in the resource-poor setting where other causes of encephalopathy caused by infection are common, and highlight the value of neuroradiological imaging.

  2. Chapter 3. Toll-like receptors (TLRs) in Brain Abscess

    PubMed Central

    Esen, Nilufer; Kielian, Tammy

    2014-01-01

    Brain abscesses arise from a localized parenchymal infection, typically elicited by pyogenic bacteria such as S. aureus. Despite improvements in detection and treatment strategies, brain abscesses continue to occur, with an increased prevalence in developing countries and immune compromised patients. Adding to the seriousness of these infections is the recent emergence of antibiotic-resistant strains of bacteria, which are becoming more commonly associated with brain abscesses. Recent studies using a mouse experimental brain abscess model have revealed a complex role for Toll-like receptors (TLRs) in disease pathogenesis. Interestingly, TLR2 has limited impact on the innate immune response during the acute stage of brain abscess formation induced by S. aureus but influences adaptive immunity. In contrast, mice deficient in MyD88, a central adaptor molecule for the majority of TLRs in addition to the IL-1R and IL-18R, demonstrate severe defects in innate immunity coupled with exaggerated tissue destruction. It is envisioned that understanding the roles for TLRs in both resident CNS glia as well as infiltrating immune cells will provide insights as to how the immune response to bacterial infection can be tailored to achieve effective pathogen destruction without inducing excessive bystander damage of surrounding non-infected brain parenchyma. A discussion of recent findings in this field is presented along with outstanding questions and the concept of a pathogen-necrosis-autoantigen triad for the amplification for TLR signaling is introduced. PMID:19688327

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

    PubMed

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

    2016-06-01

    We report an extremely rare case of Porphyromonas gingivalis causing brain abscess in a patient with recurrent periodontitis. The patient presented with right-sided homonymous hemianopsia and right hemiparesis. Emergent surgical drainage was performed and antibiotics were administered. P. gingivalis was identified from the anaerobic culture of the abscess. The clinical course of the patient improved with full recovery of the neurologic deficit. PMID:27085200

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

    PubMed

    Morita, Keiichi; Fukuzawa, Hiroaki; Maeda, Kosaku

    2015-12-01

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

  5. The role of Streptococcus intermedius in brain abscess.

    PubMed

    Mishra, A K; Fournier, P-E

    2013-04-01

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

  6. Staging of human brain abscess by computed tomography

    SciTech Connect

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

    1983-03-01

    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.

  7. Analysis of brain abscess after penetrating craniocerebral injuries in Vietnam.

    PubMed

    Rish, B L; Caveness, W F; Dillon, J D; Kistler, J P; Mohr, J P; Weiss, G H

    1981-11-01

    A population of 1221 patients from the Vietnam War with penetrating craniocerebral trauma was analyzed. Thirty-seven cases of brain abscess were documented (incidence 3%). This sequela occurred more frequently in association with extensive, deep penetrating injuries; deep, prolonged coma; cerebrospinal fluid fistulas; wound infections; facio-orbital cranial/air sinus injuries; and retained bone fragments. The mortality rate was 54%, and, of the patients who survived, 82% had significant morbidity. This is the last large population study of brain abscess after penetrating craniocerebral trauma before the availability of computed tomographic scanning and more comprehensive coma care. It should serve as base line data against which we can measure improvement.

  8. Brain abscess after endosaccular embolisation of a cerebral aneurysm.

    PubMed

    Chen, Guangzhong; Zhan, Shengquan; Chen, Wei; Li, Zhaojie; Zhou, Dong; Zeng, Shaojian; Lin, Xiaofeng; Tang, Kai; Zhou, Dexiang; Shu, Hang

    2014-01-01

    Endovascular embolization has become an important treatment option for cerebral aneurysms, along with surgical clipping. But few literatures mentioned infectious complications after coiling of aneurysms. We present a patient with a brain abscess that developed after endosaccular embolization of a left middle cerebral artery aneurysm. The brain abscess was located adjacent to the aneurysm and discovered more than 2 months after embolization. We discuss the clinical implications of this rare complication and review the literature for infections related to the coils used for embolization of aneurysms.

  9. First report of a brain abscess caused by Nocardia veterana.

    PubMed

    Arends, J E; Stemerding, A M; Vorst, S P; de Neeling, A J; Weersink, A J L

    2011-12-01

    Among Nocardia species causing infections, Nocardia veterana is rarely isolated and is mostly described as causing pulmonary infections. This is the first presentation of a case of brain abscess attributable to an N. veterana infection in a patient with type 2 diabetes. Prolonged antibiotic therapy with trimethoprim-sulfamethoxazole led to successful clinical recovery.

  10. Abscess

    MedlinePlus

    ... abscesses resolve quickly once appropriately treated. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of "staph" bacteria resistant to antibiotics in the penicillin family, which have been the ...

  11. Abscess

    MedlinePlus

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

  12. Abscess

    MedlinePlus

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

  13. [Current concepts in the management of pyogenic brain abscesses].

    PubMed

    Badreddine, Kilani; Lamia, Ammari; Emna, Mnif; Hanene, Tiouiri; Fakher, Kanoun; Ahmed, Goubontini; Chahib, Marrakchi; Faycel, Zouiten; Taoufik, Ben Chaabène

    2005-07-01

    Brain abscesses are severe infections with lethal outcome in the case of delay in diagnosis and treatment. The authors report their experience about 30 patients with pyogenic brain abscesses treated between 1989 and 2000. The goal of the study is to analyse epidemiological, clinical and therapeutic aspects of this disease. The sex ratio (M:W) was 2,3 and the mean age was 34 years. Predisposing factors were sepsis of adjacent organs (53%) and bacteremia (30%). The clinical manifestations were: fever (83%), headaches (90%) and focal neurologic signs (57%). CT-scan findings were single lesions in 80% of cases. CT-scan showed a deep ring-enhancing lesion with surrounding edema in 77% of cases. Bacteriological agents in 13 cases (43%) were: 4 Staphylococcus aureus, 2 Neisseria meningitidis and 7 negative Gram bacilli. Medical treatment alone was in 77% of cases; seven patients benefited from medical and neurosurgical approaches. Death occured in 10% of cases.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2012-09-01

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

  16. Atypical pyogenic brain abscess evaluation by diffusion-weighted imaging: diagnosis with multimodality MR imaging.

    PubMed

    Ozbayrak, Mustafa; Ulus, Ozden Sila; Berkman, Mehmet Zafer; Kocagoz, Sesin; Karaarslan, Ercan

    2015-10-01

    Whether a brain abscess is apparent by imaging depends on the stage of the abscess at the time of imaging, as well as the etiology of the infection. Because conventional magnetic resonance imaging (MRI) is limited in its ability to distinguish brain abscesses from necrotic tumors, advanced techniques are required. The management of these two disease entities differs and can potentially affect the clinical outcome. We report a case having atypical imaging features of a pyogenic brain abscess on advanced MRI, in particular, on diffusion-weighted and perfusion imaging, in a patient with osteosarcoma undergoing chemotherapy.

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

    PubMed

    Kragha, K O

    2016-01-01

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

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

    PubMed Central

    2016-01-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed Central

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

    2014-01-01

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

  1. Concomitant lung and brain abscesses: a rare presentation of a common bacteria.

    PubMed

    Mutneja, Rahul; Shah, Mamta; Silverstein, Nicole

    2014-01-01

    Streptococcusanginosusis a member of the Streptococcus millerigroup, known to cause suppurative infections of the deep tissues. There have been very few case reports of the bacteria presenting with concomitant lung and brain abscesses. We describe a patient with new, onset seizures, subsequently diagnosed with S. anginosuslungandbrain abscesses.

  2. Brain abscess after transnasal intracranial penetration of a paint-brush.

    PubMed

    de Tribolet, W; Guignard, G; Zander, E

    1979-03-01

    The case of a brain abscess caused by intracranial, transnasal penetration of a paint-brush is presented. The danger that such foreign bodies may remain unnoticed, especially in children, is stressed. Cure was achieved by total resection of the abscess capsule. PMID:473011

  3. Brain abscess and subdural empyema. Factors influencing mortality and results of various surgical techniques.

    PubMed Central

    Van Alphen, H A; Dreissen, J J

    1976-01-01

    The authors review the results of various surgical techniques in relation to mortality and morbidity in 100 consecutive cases of brain abscess and subdural empyema. The mortality rate is the same with total excision and fractional drainage of brain abscesses, although in acute and subacute cases slight differences between both techniques are seen. In terms of morbidity, fractional drainage appears to be more favourable than total excision. The authors believe that factors other than surgical procedure influence mortality in cases of brain abscess and subdural empyema. These factors are defined in detail. Images PMID:932767

  4. [Brain abscess mediated through a pulmonary arteriovenous malformation in a patient with hereditary hemorrhagic telangiectasia].

    PubMed

    Tsujimoto, Kohei; Moriya, Masayuki; Yaka, Keiko; Kawasaki, Yuko; Nakatani, Rie; Naba, Ichiro; Nakano, Misa; Tatsumi, Chikao; Yasumoto, Taku; Kawahara, Ryuji

    2014-01-01

    The patient is a 66-year-old man with hereditary telangiectasia. He was diagnosed with pulmonary arteriovenous malformation (PAVM), which was revealed by contrast-enhanced chest computed tomography at the age of 65. He developed headache, right homonymous hemianopsia, and right hemiparesis and was admitted to our hospital. Contrast-enhanced magnetic resonance imaging revealed multiple lesions in the left hemisphere, which indicates brain abscesses. Thus, the diagnosis of brain abscess mediated through PAVM was established. Following management with drainage and coil embolization, all neurological symptoms resolved. Therefore, coil embolization should be considered for PAVM at an early stage to prevent brain abscess, even if it is asymptomatic. PMID:24807278

  5. Indium-111-granulocyte scintigraphy in brain abscess diagnosis: Limitations and pitfalls

    SciTech Connect

    Schmidt, K.G.; Rasmussen, J.W.; Frederiksen, P.B.; Kock-Jensen, C.; Pedersen, N.T. )

    1990-07-01

    The scintigrams and records of 28 patients referred for indium-111-granulocyte scintigraphy (111In-GS) because of a suspected brain abscess were studied retrospectively. The final diagnosis was brain abscess in 8 patients, brain tumor in 18 patients, and infarct and hematoma in 1 patient each. Five patients not on corticosteroid treatment showed intense focal 111In accumulation in abscesses, whereas an abscess patient receiving a high steroid dose showed no uptake. Two patients studied twice showed intense uptake in abscesses when not on steroid therapy or on a low dose, whereas no uptake was seen when they received high or medium doses. Weak or moderate 111In uptake was observed in nine tumors. Microscopically assessed degree of tumor granulocyte infiltration, vessel proliferation, and hemorrhage did not correlate with the outcome of 111In GS. Our results suggest that intense focal cerebral 111In uptake favors the abscess diagnosis. Abscesses may go undetected, however, in patients on high- or medium-dose steroid therapy.

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

    PubMed

    Inamasu, Joji; Moriya, Shigeta; Kawazoe, Yushi; Nagahisa, Shinya; Hasegawa, Mitsuhiro; Hirose, Yuichi

    2015-01-01

    Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI) revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative) is more appropriate in patients with primary intraventricular brain abscesses. PMID:26351446

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

    PubMed Central

    Inamasu, Joji; Moriya, Shigeta; Kawazoe, Yushi; Nagahisa, Shinya; Hasegawa, Mitsuhiro; Hirose, Yuichi

    2015-01-01

    Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI) revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative) is more appropriate in patients with primary intraventricular brain abscesses. PMID:26351446

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

    PubMed

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

    2010-05-01

    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

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

    PubMed Central

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

    2016-01-01

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

  10. High extracellular levels of potassium and trace metals in human brain abscess.

    PubMed

    Dahlberg, Daniel; Ivanovic, Jugoslav; Mariussen, Espen; Hassel, Bjørnar

    2015-03-01

    Brain abscesses frequently cause symptoms such as seizures, delirium, paresis and sensory deficits that could reflect brain edema, increased intracranial pressure, or tissue destruction. However, it is also possible that pus constituents could disturb neuronal function in the surrounding brain tissue. In pus from 16 human brain abscesses, extracellular potassium ([K(+)]o) was 10.6 ± 4.8 mmol/L (mean ± SD; maximum value 22.0 mmol/L). In cerebrospinal fluid (CSF), [K(+)]o was 2.7 ± 0.6 mmol/L (N = 14; difference from pus p < 0.001), which is similar to previous control values for [K(+)]o in CSF and brain parenchyma. Zinc and iron were >40-fold higher in pus than in CSF; calcium, copper, manganese, and chromium were also higher, whereas sodium and magnesium were similar. Pus from 10 extracerebral abscesses (empyemas) also had higher [K(+)]o, zinc, iron, calcium, copper, manganese, and chromium than did CSF. Brain abscess [K(+)]o was significantly higher than serum potassium (3.8 ± 0.5 mmol/L; p = 0.0001), indicating that the elevated abscess [K(+)]o originated from damaged cells (e.g. brain cells and leukocytes), not from serum. High [K(+)]o could depolarize neurons, high levels of zinc could inhibit glutamate and GABA receptors, and high levels of iron and copper could cause oxidative damage, all of which could contribute to neuronal dysfunction in brain abscess patients. PMID:25684071

  11. High-resolution ultrasound evaluation of experimental brain abscess evolution: comparison with computed tomography and neuropathology.

    PubMed

    Enzmann, D R; Britt, R H; Lyons, B; Carroll, B; Wilson, D A; Buxton, J

    1982-01-01

    Computed tomographic (CT) and high-resolution ultrasound (HRUS) imaging of experimental brain abscess were correlated with neuropathologic findings in nine mongrel dogs. The HRUS scan was more sensitive to different histologic features than the CT scan but both accurately delineated the evolution of the experimental brain abscess. All stages of abscess evolution were characterized by an appearance of an echogenic rim with a hypoechoic center. In the early stages the echogenicity of the abscess was related primarily to marked cellular infiltration, while in the late stages extensive collagen deposition correlated closely with the echo pattern. The size of the abscess in the cerebritis stages appeared smaller on the HRUS scan than on the CT scan because the latter modality detected the extensive cerebritis around the developing necrotic center whereas the HRUS scan did not. This discrepancy disappeared in the capsule stages. The HRUS scan provided a more accurate depiction of the neuropathologic characteristics of the necrotic than did the CT scan. Healing of the abscess, indicated by a decrease in size of the hypoechoic center, was accurately detected by the HRUS scan. PMID:7053556

  12. High-resolution ultrasound evaluation of experimental brain abscess evolution: comparison with computed tomography and neuropathology

    SciTech Connect

    Enzmann, D.R.; Britt, R.H.; Lyons, B.; Carroll, B.; Wilson, D.A.; Buxton, J.

    1982-01-01

    Computed tomographic (CT) and high-resolution ultrasound (HRUS) imaging of experimental brain abscess were correlated with neuropathologic findings in nine mongrel dogs. The HRUS scan was more sensitive to different histologic features than the CT scan but both accurately delineated the evolution of the experimental brain abscess. All stages of abscess evolution were characterized by an appearance of an echogenic rim with a hypoechoic center. In the early stages the echogenicity of the abscess was related primarily to marked cellular infiltration while in the late stages extensive collagen deposition correlated closely with the echo pattern. The size of the abscess in the cerebritis stages appeared smaller on the HRUS scan than on the CT scan because the latter modality detected the extensive cerebritis around the developing necrotic center whereas the HRUS scan did not. This discrepancy disappeared in the capsule stages. The HRUS scan provided a more accurate depiction of the neuropathologic characteristics of the necrotic center than did the CT scan. Healing of the abscess, indicated by a decrease in size of the hypoechoic center, was accurately detected by the HRUS scan.

  13. Brain abscess in a rhesus macaque (Macaca mulatta) with a cephalic implant.

    PubMed

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

    2013-08-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2015-03-01

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

  16. [Specific features of rhino-sinusogenic brain abscesses in adults and children].

    PubMed

    Blagoveshchenskaia, N S; Mukhamedzhanov, N Z

    1989-01-01

    Analysis of observations of 49 patients with rhinosinusogenic brain abscesses revealed differences in their development between adults and children. This pathology occurs in adults more frequently than in children, particularly young children. In adults, brain abscesses usually develop as a result of chronic frontal- or polysinusitis, while in children they typically occur after maxillary sinusitis and in early age children also after acute suppuration in the nasal cavity. For adults, the contact pathway of infection is characteristic, whereas for children, the hematogenic-metastatic pathway is typical. Adults show single abscesses while children show both single, multiple and multichamber abscesses accompanied by separation of cranial sutures, thinning of calvaria, and protrusion and tension of the cranial fontanel. In children, abscesses may grow very large. In adults, the hypertensive syndrome is very distinct, while in children, the hydrocephalic-hypertensive syndrome comes to the foreground. In children, infectious-toxic symptoms are more significant. In adults, focal neurological symptoms become more serious than in children in whom they are also more labile.

  17. Aerotolerant Clostridium tertium brain abscess following a lawn dart injury.

    PubMed Central

    Lew, J F; Wiedermann, B L; Sneed, J; Campos, J; McCullough, D

    1990-01-01

    A young girl developed an intracranial abscess and necrotizing cellulitis following penetrating injury from a lawn dart. Initial identification of a gram-positive rod growing aerobically from clinical specimens was as a Bacillus organism, but the observation that the isolate grew poorly in subcultures for susceptibility testing but quite well under standard anaerobic culture techniques led to the identification of the organism as an aerotolerant Clostridium tertium. Early management of penetrating head trauma should include cranial imaging studies to detect fractures and intracranial pathology. Clinical microbiologists and clinicians should be aware of the phenomenon of aerotolerance in anaerobic bacteria to avoid errors in choice of antibiotic therapy. Images PMID:2229397

  18. Prevotella brain abscesses and stroke following dental extraction in a young patient: a case report and review of the literature.

    PubMed

    Wu, Pin-Chieh; Tu, Ming-Shium; Lin, Po-Hsiang; Chen, Yao-Shen; Tsai, Hung-Chin

    2014-01-01

    A brain abscess is a life-threatening infection. There are few reports describing Prevotella bacteremia with middle cerebral artery (MCA) occlusion and brain abscess following dental extraction in the literature. We herein describe a 32-year-old healthy man who experienced headache after tooth extraction. He was not correctly diagnosed until he experienced a stroke and a blood culture revealed Prevotella denticola weeks later. This case and our detailed review of related cases highlight the importance of thorough medical history-taking and clinical evaluations. Brain abscess formation should be considered in previously healthy patients with fever, stroke, and a recent history of tooth extraction. PMID:25130130

  19. Brain metastasis from a lung mucoepidermoid carcinoma mimicking a brain abscess

    PubMed Central

    Saito, Taiichi; Ujiie, Hiroshi; Kadoyama, Shigeru; Higa, Takashi; Shiono, Saori; Teramoto, Akira

    2015-01-01

    Background: Mucoepidermoid carcinoma (MEC) is a rare tumor of the lung that accounts for 0.1–0.2% of all pulmonary tumors. To the best of our knowledge, brain metastasis from lung MEC is rare and magnetic resonance imaging (MRI) findings of this lesion have not been documented. Case Description: We herein report the case of a 72-year-old male. MRI revealed a left parietal tumor showing ring enhancement with medium gadolinium contrast and an evident high intensity area in the nonenhanced central portion on diffusion-weighted images (DWI) mimicking a brain abscess. Histologically, MEC is composed of a mixture of different cell types including mucin-secreting glandular cells and squamous cells. Accordingly, we suggest that the high DWI signal can be explained by the development of intracellular and intraluminal mucin, which have a high viscosity. Conclusion: Further accumulation of cases with brain metastasis from MEC is needed to establish the characteristic image findings, which would lead to prompt and adequate treatment. PMID:26167374

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

    PubMed

    Lee, Thomas; Green, Ross; Hsu, Jack

    2013-06-01

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

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

    PubMed

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

    2013-12-01

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

  2. Cladophialophora bantiana: a rare cause of fungal brain abscess. Clinical aspects and new therapeutic options.

    PubMed

    Garzoni, Christian; Markham, Lydia; Bijlenga, Philippe; Garbino, Jorge

    2008-08-01

    Black molds or dematiaceous fungi are rare etiologic agents of intracerebral abscesses and such infections carry a high mortality of up to 70% despite combined surgical and antifungal therapy. While the growing use of immunosuppressive therapies and organ transplantation have caused an increase in the incidence of rare fungal cerebral infections, occurrence in immunocompetent hosts is also possible. We describe a 60-year-old female patient with a cerebral abscess caused by Cladophialophora bantiana. The case illustrates the clinical and radiological similarities between glioblastomas and brain abscesses and emphasizes the need to perform histological and microbiological studies prior to the initiation of any form of therapy. Long-term survival from cerebral black mold abscesses has been reported only when complete surgical resection was possible. The recommended antifungal treatment involves the use of amphotericin B combined with a triazole and, if possible, flucytosine. Highly-active new generation triazole antifungal compounds (voriconazole or posaconazole) are likely to offer improved survival rates for patients with rare mold infections. In particular, posaconazole could be a new therapeutic option given its better tolerance, lower toxicity and fewer drug-drug interactions. We discuss clinical, microbiological and practical pharmacological aspects and review current and evolving treatment options.

  3. Risk Factors Associated with Poor Outcomes in Patients with Brain Abscesses

    PubMed Central

    Ko, Seok-Jin; Park, Dong-Hyuk; Kang, Shin-Hyuk; Park, Jung-Yul; Chung, Yong-Gu

    2014-01-01

    Objective The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ≥4] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ≥13) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (≥140 mg/dL) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents. PMID:25289123

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-03-01

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

  9. [OPTIMIZATION OF THE TREATMENT TACTICS IN BRAIN ABSCESS, USING THE PUNCTURE STEREOTAXIC ASPIRATION].

    PubMed

    Zihnkevych, Ya P; Borshchov, S P; Kostyuk, K R; Malysheva, T A

    2015-12-01

    There was analyzed the application efficacy of stereotaxic aspiration of the brain abscess (BA) content, localized in a deep and functionally significant parts of the brain, in 12 patients--with supratentorial BA. Stereotaxic interventions were performed, using stereotaxic systems CRW Radionics (USA) and the security program for calculation of coordynates StereoFusion, StereoPlan (Radionics), Fraime Link (Medtronic, USA). Postoperative observation period have lasted from 1 to 36 mo, (14 ± 3.6) mo at average. lntraoperatively in 11 (91.7%) patients a purulent content of BA was evacuated, and in 1 (8.3%)--a BA was diagnosed in the encephalitis stage. Stereotaxic aspiration is an effective and secure method of surgical treatment of BA. It may constitute an alternative to open surgical excision of BA due to lesser invasiveness and possibility of the neurological complications occurrence. PMID:27025026

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

    PubMed Central

    Aydin, Gerilmez; Cömert, Serhat; Altinors, Nur

    2010-01-01

    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. PMID:20717517

  11. Anesthesia for a Rare Case of Uncorrected Pentalogy of Fallot Undergoing Craniotomy and Drainage of Brain Abscess

    PubMed Central

    Raghavavendra, B.S.

    2015-01-01

    Children with uncorrected cyanotic congenital heart diseases can present for non cardiac surgeries. They pose several challenges to the Anaesthesiologist, especially when they are posted for emergency surgery, due to the complex haemodynamic changes secondary to the heart disease. Pentalogy of Fallot (POF) is a rare form of congenital heart disease characterized by the association of Tetralogy of Fallot (TOF) with an atrial septal defect (ASD). TOF is the leading cause of intracardiac right to left shunt and is the commonest type of cyanotic congenital heart disease to cause a brain abscess. Children with POF presenting with brain abscess pose several challenges to the anaesthesiologist due to the altered haemodynamics and warrant a meticulous anaesthetic plan. There are very few case reports of Anaesthesia management of a child with Pentalogy of Fallot (POF) presenting for non cardiac surgery. We report the anaesthetic management of a rare case of a 5-year-old child with uncorrected POF, who presented to our Superspeciality hospital with a brain abscess and underwent an emergency craniotomy with drainage of the brain abscess successfully. PMID:26393185

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

    PubMed Central

    2014-01-01

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

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

    SciTech Connect

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

    1982-10-01

    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.

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

    PubMed Central

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

    2016-01-01

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

  15. Phocaeicola abscessus gen. nov., sp. nov., an anaerobic bacterium isolated from a human brain abscess sample.

    PubMed

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

    2009-09-01

    A strictly anaerobic bacterial strain, 7401987T, was isolated from a human brain abscess sample. Cells were Gram-negative, non-spore-forming, coccoid to rod-shaped and motile by flagella in a lophotrichous arrangement. The isolate was asaccharolytic and the major cellular fatty acids were anteiso-C15:0 (28.2%), C16:0 (18.0%), iso-C15:0 (12.3%) and iso-C17:0 3-OH (11.7%). 16S rRNA gene sequence comparisons showed that the isolate was distantly related to members of the genera Bacteroides (<83.6% similarity), Parabacteroides (<79.9% similarity), Tannerella (<79.8% similarity), Dysgonomonas (<79.6% similarity), Porphyromonas (<79.3% similarity) and Prevotella (<78.9% similarity). The low 16S rRNA gene sequence similarity values and physiological and biochemical characteristics differentiated strain 7401987T from all known species and indicate that our isolate represents a novel species in a new genus within the phylum Bacteroidetes. The name Phocaeicola abscessus gen. nov., sp. nov. is proposed; the type strain of Phocaeicola abscessus is 7401987T (=CCUG 55929T=CSUR P22T=DSM 21584T). PMID:19620382

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

    PubMed

    Farran, Yvette; Antony, Suresh

    2016-01-01

    Nocardia infections primarily begin in the lungs and spread hematogenously to other sites in the body. Thus, a Nocardia brain abscess is not a completely uncommon occurrence. However, a Nocardia brain abscess complicated by a middle cerebral artery and infectious intracranial aneurysm is a very rare clinical entity. We present a case of an infectious intracranial aneurysm with an associated Nocardia brain abscess that required surgical intervention and resection. The patient was an immunocompetent 60-year-old male who presented with a chief complaint of headache and was found to have an infected intracranial aneurysm and cerebral abscess. He underwent drainage of the abscess with subsequent resection of the infected aneurysm. Cultures from both the blood vessel and brain tissue grew Nocardia abscessus. He was successfully treated with 6 weeks of ceftriaxone and high-dose trimethoprim-sulfamethoxazole. Infectious intracranial aneurysms of the brain caused by Nocardia are rare occurrences, and only a single previous case has been described in the literature. The outcomes of this condition can be catastrophic if it is not treated with a combination of surgery and intravenous antibiotics. The guidelines for the management of this infection are not well defined at this time. PMID:26724261

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

    PubMed

    Farran, Yvette; Antony, Suresh

    2016-01-01

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

  18. Osteoma of the frontoethmoidal sinus with secondary brain abscess and intracranial mucocele: case report.

    PubMed

    Shady, J A; Bland, L I; Kazee, A M; Pilcher, W H

    1994-05-01

    The authors report the case of a 17-year-old patient with an osteoma of the frontoethmoidal sinus who had a secondary abscess of the frontal lobe and an intracranial mucocele. Clinical, radiological, and surgical correlates of this triad are presented.

  19. Subareolar abscess

    MedlinePlus

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-01-01

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

  2. [Brodie's abscess].

    PubMed

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

    1993-08-10

    Brodie's abscess is a localized subacute or chronic osteomyelitis independent of any known previous acute infection. The entity is often mistaken for a bone tumour. The diagnosis requires biopsy. The treatment is curettage, drainage and antibiotics for a minimum of six weeks. We describe the characteristics of Brodie's abscess and describe a patient with an illustrating history, but with an unusual localization of the abscess (osilium).

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

    PubMed Central

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

    2016-01-01

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

  4. [Lingual abscess].

    PubMed

    Benito, J I; Martín, G; Morais, D; del Monte, J M

    2000-01-01

    The unilateral abscess of the anterior portion of the tongue is an extremely rare occurrence. We report a case in which we have used the ultrasonography in the diagnosis, and discuss, as etiologic hypothesis the participation of Blandin-Nühn glands in the genesis of these abscess.

  5. Hepatic abscesses

    PubMed Central

    Rajagopalan, S.; Langer, V.

    2012-01-01

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

  6. Fatal Klebsiella pneumoniae meningitis and emphysematous brain abscess after endoscopic variceal ligation in a patient with liver cirrhosis and diabetes mellitus.

    PubMed

    Shih, Hsin-I; Lee, Hsin-Chun; Chuang, Chiao-Hsiung; Ko, Wen-Chien

    2006-10-01

    Procedure-related bacterial infections may complicate esophageal variceal ligation in cirrhosis patients. Here, we report a 58-year-old man with underlying diabetes and liver cirrhosis who developed Klebsiella pneumoniae meningitis and brain abscess with gas formation in brain parenchyma and ventricles after this procedure. Despite administration of appropriate antimicrobial therapy, he became comatose on the 3rd day of acute illness and died on the 4th day of hospitalization. This case highlights the indication for antimicrobial prophylaxis in cirrhotic patients with gastrointestinal bleeding, and the need for early and heightened awareness of central nervous system infections in cirrhotic patients with hepatic encephalopathy.

  7. Pancreatic abscess.

    PubMed Central

    Gartell, P C

    1982-01-01

    Three cases of pancreatic abscess are described to show the difficulties in diagnosis and that inadequate treatment is invariably fatal. Early recognition and prompt surgical drainage, together with biliary decompression if indicated, are advised. PMID:7069670

  8. Skin abscess

    MedlinePlus

    ... abscesses may occur after: A bacterial infection (often staphylococcus) A minor wound or injury Boils Folliculitis (infection ... Daum RS. Staphylococcus aureus . In: Long SS, ed. Principles and Practice ... Diseases. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012: ...

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

    SciTech Connect

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

    2011-02-15

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

  10. Meningoencephalitis and brain abscess due to a free-living amoeba.

    PubMed

    Duma, R J; Helwig, W B; Martinez, A J

    1978-04-01

    A 47-year-old diabetic woman developed fatal meningoencephalitis due to a free-living amoeba. The responsible organism appeared to be neither Naegleria nor Acanthamoeba-Hartmannella. Both acute and chronic (granulomatous) inflammatory reactions of the brain were present, and both cysts and trophozoite forms were readily visualized. The latest classification and methods of identification of such amoebae are reviewed and their threat to public health underscored. It should be realized that a variety of free-living amoebae exist in nature, which potentially can produce meningoencephalitis in humans, and that none of these organisms should be labeled or considered as "avirulent" or "nonpathogenic" until proved otherwise. PMID:637425

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

    SciTech Connect

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

    2006-06-15

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

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

    PubMed

    Sarica, Feyzi Birol; Tufan, Kadir; Cekinmez, Melih; Erdoğan, Bülent; Altinörs, Mehmet Nur

    2009-07-01

    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.

  13. Pyogenic liver abscess

    MedlinePlus

    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 ...

  14. Abscess in the Lungs

    MedlinePlus

    ... abscesses are streptococci and staphylococci, including methicillin-resistant Staphylococcus aureus (MRSA), which is a serious infection. Obstruction ... night sweats. In contrast, lung abscesses caused by Staphylococcus aureus or MRSA can be fatal within days, ...

  15. Abscess - abdomen or pelvis

    MedlinePlus

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

  16. Abscess scan - radioactive

    MedlinePlus

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

  17. Symmetrical Brodie's abscess.

    PubMed Central

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

    1997-01-01

    Chronic recurrent multifocal osteomyelitis is often confused with symmetrical Brodie's abscess as it has a similar pathogenesis. We report an otherwise healthy 17-year-old boy presenting with a true symmetrical Brodie's abscess. We conclude that a symmetrical Brodie's abscess presenting in an otherwise healthy patient is a separate clinical condition with a different management protocol. Images Figure 1 Figure 2 PMID:9497984

  18. Symmetrical Brodie's abscess.

    PubMed

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

    1997-10-01

    Chronic recurrent multifocal osteomyelitis is often confused with symmetrical Brodie's abscess as it has a similar pathogenesis. We report an otherwise healthy 17-year-old boy presenting with a true symmetrical Brodie's abscess. We conclude that a symmetrical Brodie's abscess presenting in an otherwise healthy patient is a separate clinical condition with a different management protocol.

  19. Thalamic abscess caused by a rare pathogen: streptococcus constellatus

    PubMed Central

    Şenol, Özgür; Süslü, Hikmet Turan; Tatarlı, Necati; Tiryaki, Mehmet; Güçlü, Bülent

    2016-01-01

    Streptococcus constellatus is a microorganism that lives commensally in the oropharyngeal region, urogenital region, and intestinal tract. However, it can cause infection in patients with certain predisposing factors. Rarely, this microorganism can cause a brain abscess. Thalamic localization of brain abscesses is much rarer than abscesses in other locations of the brain. Brain abscess caused by streptococcus constellatus are very rarely been reported in the literature. We present a rare case of a left-sided thalamic abscess caused by streptococcus constellatus in a 25-year-old male patient who was injured by shrapnel pieces in the head and who was malnourished. The patient was successfully treated by stereotactic aspiration and antibiotherapy. PMID:27800109

  20. Pyogenic liver abscess caused by Gemella morbillorum.

    PubMed

    Borro, Paolo; Sumberaz, Alessandro; Testino, Gianni

    2014-01-01

    Even though Gemella morbillorum infection (GMI) is rare in humans, it may nevertheless, cause endocarditis, meningitis, brain abscess, pleural empyema, nephritis, mediastinitis, and--occasionally--liver abscess. We are describing the case of a 64-years-old Caucasian male admitted with fever and abdominal pain. Laboratory parameters revealed inflammation signs, and instrumental examinations showed the presence of diverticula in the ascending colon. Abdominal ultrasound (US) and computer tomography (CT) showed two focal lesions in the right liver lobe. One had the characteristics of a simple cyst; the second was hypoechoic with a low density area, possibly containing necrotic material. US-guided needle biopsy was found negative for neoplastic cells, showing purulent infiltrate. Pus culture was found positive for GMI. Systemic antibiotic therapy coupled with repeated US-guided needle aspiration, induced the resolution of the hepatic abscess. Few cases have been reported of hepatic abscess caused by GMI in immunocompetent non-cirrhotic subjects.

  1. Spontaneous cholecystocutaneous abscess.

    PubMed

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

    2010-01-01

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

  2. Amebic liver abscess

    MedlinePlus

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

  3. Brodie's abscess revisited.

    PubMed

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

    2010-01-01

    Radiology plays an important role in the diagnosis of a Brodie's abscess, as can be difficult for a clinician to identify the disease using clinical information alone. A Brodie's abscess is clinically difficult to diagnose because patients typically have mild local symptoms, few or no constitutional symptoms, and near normal laboratory values. Furthermore, a Brodie's abscess may mimic various benign and malignant conditions, resulting in delayed diagnosis and treatment. The most frequently made incorrect diagnosis is that of a primary bone tumor. The present pictorial review summarizes imaging clues to the diagnosis of a Brodie's abscess, such as the serpentine sign on conventional radiographs and the penumbra sign seen on Magnetic Resonance (MR) images. A Brodie's abscess is difficult to diagnose, however, once diagnosed, it is a curable disease with a 100% cure rate.

  4. Klebsiella pneumoniae splenic abscess.

    PubMed

    Gill, V; Marzocca, F J; Cunha, B A

    1994-01-01

    Splenic abscesses may be solitary or multiple and are unusual infections. Signs and symptoms are variable and do not always include left upper quadrant pain or tenderness, as the Case Report illustrate. Abscesses of the spleen may occur as a result of endocarditis or from hematogenous seeding from a distant focus of infection. Computed tomographic scan of the spleen is the diagnostic method of choice. We report a case of multiple splenic abscesses caused by Klebsiella pneumoniae that resulted from a Klebsiella urinary tract infection and was successfully managed with antibiotic therapy and splenectomy. PMID:8039997

  5. Nonsurgical drainage of splenic abscess

    SciTech Connect

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

    1983-08-01

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

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

    PubMed

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

    2014-06-01

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

  7. Spinal cord abscess

    MedlinePlus

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

  8. Anorectal abscess during pregnancy.

    PubMed

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

    2014-02-01

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

  9. [Psoas abscesses reviewed].

    PubMed

    Loussaïef, Chawki; Toumi, Adnen; Chakroun, Mohamed; Ben Brahim, Hajer; Ben Romdhane, Foued; Bouzouaïa, Noureddine

    2006-02-01

    Psoas abscesses are rare. In the absence of specific symptoms and signs, their diagnosis was usually difficult. Medical imaging advances have helped in their diagnosis and treatment. Eleven cases of psoas abscess were reviewed retrospectively. We tried to determine epidemiologic and clinical features and therapeutic alternatives for this entity. Mean aged 27 years. Three of the 11 cases occurred in females. An underlying disease was observed in three cases. Associated clinical features were fever (n = 11), lumbar pain (n = 10), and psoOtis (n = 5). Diagnosis was confirmed by ultrasonography (n = 10) and computed tomography (n = 1). Blood culture was positive in 6 out of 11 cases: Staphylococcus aureus (n = 5) and Klebsiella pneumonia (n = 1) Staphylococcceus aureus was isolated in 6 abscess pus. Antibiotics were prescribed in all cases for a mean length of 61 days, in association with percutaneous drainage in 5 cases, surgical drainage in one case and abscess puncture in one case. Outcome was favourable in all cases.

  10. Aspergillus spinal epidural abscess

    SciTech Connect

    Byrd, B.F. III; Weiner, M.H.; McGee, Z.A.

    1982-12-17

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

  11. [Brain abscess caused by Streptococcus pyogenes as a complication of acute otitis media in 7-year-old girl - a case report].

    PubMed

    Załęska-Ponganis, Joanna; Jackowska, Teresa

    2013-01-01

    Acute otitis media (AOM) is the most commonly diagnosed childhood disease, especially in infants and preschool children. Onset of AOM encourage frequent upper respiratory infections and debilitating conditions that cause nasal patency and trumpets auditory dysfunction. Complications of AOM currently are rare. We present a case of complications of acute otitis media in form of acute cerebral abscess in a 7-year-old previously healthy girl.

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

    PubMed

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

    2015-01-01

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

  13. Enterococcal Cerebellopontine Angle Abscess in a 12-year-old Female.

    PubMed

    Sonavane, Alka; Baradkar, Vasant; Kumar, Simit

    2010-01-01

    Despite advances in imaging and antibiotic treatment, brain abscess is still encountered occasionally. Various aerobic and anaerobic bacteria have been reported as causative agents of brain abscess but only a few cases of enterococcal brain abscesses have been reported. Here we report a case of brain abscess in a 12-year-old female patient, who presented with a history of fever, chills, headache, convulsions since seven days and history of altered sensorium and aphasia since the last two days. The patient had chronic suppurative otitis media of both ears following trauma and presented with ear discharge. The diagnosis of brain abscess was done by computerized tomography scan and the pus was aspirated by left suboccipital burr hole operation. Enterococcus species was cultured from the aspirated pus sample. The patient responded to surgical drainage and antibiotic treatment. PMID:20300422

  14. [Paravaginal abscess in pregnancy].

    PubMed

    Hasbargen, U; Hillemanns, P; Scheidler, J; Kimmig, R; Hepp, H

    2001-10-01

    Paravaginal abscess in pregnancy. We report the diagnosis and treatment of an infected Gartner's duct cyst during pregnancy. The patient presented with lower abdominal pain, fever (38.5 degrees C) and an elevated C-reactive Protein level. Pelvic examination revealed a painful paravaginal mass. Sonography was not able to detect the cranial border of the tumor. Magnetic resonance imaging (MRI) revealed fluid accumulation laterodorsal to the vagina without evidence of a connection with the retroperitoneal space. An infected Gartner's duct cyst with consecutive abscess formation along the mesonephric duct system, was diagnosed. Following transvaginal drainage, the remainder of the pregnancy was uneventful and the patient was delivered vaginally at 40 + 5 weeks without complications. - The rare clinical finding of a paravaginal abscess in pregnancy was treated without termination of the pregnancy. Preoperative planning of the surgical approach using MRI can be easier for pelvic processes extending out of the pelvis than using ultrasound and is less painful for the patient.

  15. Hepatic abscesses after adhesiolysis

    PubMed Central

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

    2015-01-01

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

  16. Tubercular thyroid abscess.

    PubMed

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

    2013-01-01

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

  17. Hypothalamic-pituitary abscess

    PubMed Central

    Mohr, P. D.

    1975-01-01

    A case of hypothalamic-pituitary abscess is described, and previous case reports discussed. The clinical picture is one of hypopituitarism, a fluctuating clinical course with attacks of meningism, and a background of sphenoid sinusitis. ImagesFig. 1 PMID:1187501

  18. Ocular tuberculosis with multiple cerebral abscesses.

    PubMed

    Nor-Masniwati, Saidin; Zunaina, Embong; Azhany, Yaakub

    2012-01-01

    A 23-year-old Malay man presented with headache for one-month duration. It was associated with painless blurring of vision of the right eye. He had loss of appetite and reduced weight but no night sweats or hemoptysis. His visual acuity on the right eye was 6/45 and improved to 6/15 with pinhole. Right fundus examination revealed a choroidal tuberculoma located at one disc diameter away from optic disc superiorly with mild vitritis. Systemic examinations revealed no significant finding. Mantoux test reading was 22 mm with erythrocyte sedimentation rate that was 14 mm/h. Other blood investigations were negative with normal chest radiography. The computerized tomography scan of the brain revealed multiple cerebral abscesses. A clinical diagnosis of right ocular tuberculosis with multiple cerebral abscesses was made. He was treated with antituberculosis chemotherapy for one year which divided into intensive phase for three months and maintenance phase for nine months. Cerebral abscesses resolved after three months of antituberculosis drugs and at one-year follow-up, and the choroidal tuberculoma resolved completely with scar formation and significant macular striae.

  19. Fusarium solani breast abscess.

    PubMed

    Anandi, V; Vishwanathan, P; Sasikala, S; Rangarajan, M; Subramaniyan, C S; Chidambaram, N

    2005-07-01

    An unusual manifestation of breast fusariosis was encountered in a 55-year-old female diabetic patient. Two fine needle aspirates (FNA) from the abscess were done at three days interval and they showed hyaline, septate, branched, fungal hyphae in 10% potassium hydroxide mount. Fungal infection was confirmed by demonstrating the fungal hyphae in the midst of lymphocytes, macrophages and neutrophils in Leishman stained smears. Culture of both FNAs yielded a heavy and pure growth of Fusarium solani. The patient responded to oral ketoconazole 200 mg once daily for 3 weeks. The breast fusariosis reported here is presumably the first case in India. PMID:16100431

  20. Pasteurella multocida liver abscess.

    PubMed

    Cortez, J C; Shapiro, M; Awe, R J

    1986-08-01

    A previously healthy 61-year-old woman was seen with an abnormal chest roentgenogram and a 3-week history of fever, chills, malaise, and right upper quadrant pain. Blood cultures revealed Pasteurella multocida sensitive to penicillin. Liver spleen radioisotope scan and CT scan revealed space occupying lesions in the right lobe of the liver. The patient was a gardener with no pets or animal exposure. This case illustrates P. multocida septicemia and a liver abscess in a patient without animal exposure. In addition, the possibility of soil as another reservoir of infection is raised. PMID:3487981

  1. Operative treatment of Brodie's abscess.

    PubMed

    Dunn, E C; Singer, L

    1991-01-01

    This manuscript deals with a unique operative management of unilateral Brodie's abscess in a 16-year-old male. Brodie's abscess is a common finding in childhood osteomyelitis. A review of the radiographic appearance, clinical presentation, and surgical management is presented.

  2. Use of permeability surface area-product to differentiate intracranial tumours from abscess

    PubMed Central

    Ramli, N; Rahmat, K; Mah, E; Waran, V; Tan, LK; Chong, HT

    2009-01-01

    Background and Purpose Clinical and radiological findings of intracranial abscesses may mimic the findings of brain tumours and vice versa. However, the discrimination is of great clinical importance in planning treatment and in following prognosis and response to therapy. This study evaluates the Computed Tomography (CT) perfusion parameters, especially the permeability index, with the aim of evaluating the usefulness of dynamic CT perfusion imaging as an alternative tool to differentiate necrotic brain tumours and intracerebral abscesses. Materials and Methods A total of 21 patients underwent perfusion CT study and were divided into 2 groups: Group 1, patients with necrotic brain tumours (n=13); and Group 2, patients with cerebral abscesses (n=8). The mean perfusion parameters were obtained from the enhancing part of the lesion. The relative ratios were then calculated by using the results from mirrored regions within the contralateral hemisphere as reference. Results The results of this study showed that there was significant difference in the relative permeability surface values between necrotic brain tumours and cerebral abscesses (p=0.005). By applying the ROC curve, a value of 25.1 for rPS was found to be the best estimate to distinguish necrotic brain tumours from cerebral abscesses with a specificity of 88 % and sensitivity of 70 %. Conclusion CT perfusion, especially permeability surface, may allow for better differentiation of cerebral abscesses from brain tumours, making it a strong additional imaging modality in the early diagnosis of these two entities. PMID:21611026

  3. Radiological management of abdominal abscess.

    PubMed Central

    Mac Erlean, D P; Gibney, R G

    1983-01-01

    Forty-two abdominal and retroperitoneal abscesses were drained percutaneously under ultrasound guidance. A success rate of 85.7% was achieved. Subsequent surgery was required in only 5 patients. Postoperative and spontaneous abscesses did equally well. Most intra-abdominal and retroperitoneal abscesses are amenable to this form of percutaneous drainage. The procedure requires only local anaesthesia and is well tolerated. Surgical management should probably now be reserved for those cases which are considered unsuitable for percutaneous drainage or which fail to resolve following this procedure. PMID:6842496

  4. [Intramural abscesses of the rectum].

    PubMed

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

    1983-05-01

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

  5. Brodie's abscess: a case report.

    PubMed

    Alter, S A; Sprinkle, R W

    1995-01-01

    The authors present a case report with a 1-year follow-up period, demonstrating the successful diagnosis and surgical treatment of a focal lesion of the distal metaphysis of the right tibia in an 11-year-old female. The author discusses the pathology of hematologic osteomyelitis and its role in the development of a subacute abscess. A review of the literature and a detailed description of the pathogenesis of Brodie's abscess is submitted as well.

  6. Klebsiella pneumoniae liver abscess in diabetic patients: association of glycemic control with the clinical characteristics

    PubMed Central

    2013-01-01

    Background Klebsiella pneumoniae liver abscess (KPLA) has been reported with increasing frequency in East Asian countries in the past 3 decades, especially in Taiwan and Korea. Diabetes is a well-known risk factor for KPLA and highly associated with septic metastatic complications from KPLA. We investigated the association of glycemic control in diabetic patients with the clinical characteristics of KPLA in Taiwan. Methods Adult diabetic patients with KPLA were identified retrospectively in a medical center from January 2007 to January 2012. Clinical characteristics were compared among patients with different levels of current hemoglobin A1c (HbA1c). Risk factors for metastatic infection from KPLA were analyzed. Results Patients with uncontrolled glycemia (HbA1c ≥ 7%) were significantly younger than those with controlled glycemia (HbA1c < 7%). Patients with uncontrolled glycemia had the trend to have a higher rate of gas-forming liver abscess, cryptogenic liver abscess, and metastatic infection than those with controlled glycemia. Cryptogenic liver abscess and metastatic infection were more common in the poor glycemic control group (HbA1c value >; 10%) after adjustment with age. HbA1c level and abscess < 5 cm were independent risk factors for metastatic complications from KPLA. Conclusions Glycemic control in diabetic patients played an essential role in the clinical characteristics of KPLA, especially in metastatic complications from KPLA. PMID:23363608

  7. [Pancreatic abscess and infected pseudocyst].

    PubMed

    Trinidad, E E; Ramírez-Ronda, C H

    1994-01-01

    Acute pancreatitis is a sterile inflammatory process caused by a chemical auto digestion of the pancreas. The pancreatic abscess and infected pseudocyst are complications of acute pancreatitis of a high mortality rate that require a prompt diagnosis. The pseudocyst is defined as a localized collection of pancreatic juices confine to a retroperitoneal area by a fibrous membrane without epithelium; an abscess is a collection of pus and necrotic tissue. This illnesses should be suspected when patients with acute pancreatitis develop fever, tachycardia, abdominal distention or mass after 14-22 days after the initial attack. These entities require different treatment. The definite treatment is surgical intervention.

  8. [Post-surgery cerebral abscess due to Propionibacterium acnes].

    PubMed

    Zárate, Mariela S; Yahni, Diego; Guevara, Martín; Smayevsky, Jorgelina

    2009-01-01

    Brain abscesses by Propioni-bacterium acnes are rare. The rapid identification of this pathogen is important in order to choice the appropriate antibiotic therapy. We describe the case of a patient with excision of a multiform glioblastoma who 9 months later presented a tumor recurrence. A subtotal tumor excision was made and implants chemotherapy were placed in the residual tumor. After one month of surgery the patient presented a brain abscess. A craniotomy for drainage was performed. P. acnes was isolated from the biopsy and from purulent material. Identification was made by conventional biochemical tests and by the API system 20 A. The Minimum Inhibitory Concentration (MIC) to clindamycin, penicillin, amoxicillin and metronidazole was determined. The values of MIC (microg/ml) obtained were: 0.250, 0.040, 0.023 and 256, respectively. The patient received cefepime and metronidazole intravenously during 30 days and completed treatment with oral clindamycin for 60 days, considering the possibility of adjacent bone involvement. Eight months after the drainage the patient had no evidence of infection or tumor recurrence. Although P. acnes is a rare cause of post-neurosurgical infection, it should be considered as a possible pathogen in postoperative brain abscesses.

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

    PubMed

    Livingston, Lachara V; Perez-Colon, Elimarys

    2014-01-01

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

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

    PubMed Central

    Livingston, Lachara V.; Perez-Colon, Elimarys

    2014-01-01

    Streptococcus intermedius is a member of the Streptococcus anginosus group of bacteria. This group is part of the normal flora of the oropharynx, genitourinary, and gastrointestinal tracts; however, they have been known to cause a variety of purulent infections including meningitis, endocarditis, and abscesses, even in immunocompetent hosts. In particular, S. intermedius has been associated with the development of liver and brain abscesses. There have been several case reports of S. intermedius liver abscesses with active periodontal infection. To our knowledge, however, there has not been a case following a routine dental procedure. In fact, the development of liver abscesses secondary to dental procedures is very rare in general, and there are only a few case reports in the literature describing this in relation to any pathogen. We present a rare case of S. intermedius bacteremia and liver abscess following a dental cleaning. This case serves to further emphasize that even routine dental procedures can place a patient at risk of the development of bacteremia and liver abscesses. For this reason, the clinician must be sure to perform a detailed history and careful examination. Timely diagnosis of pyogenic liver abscesses is vital, as they are typically fatal if left untreated. PMID:25197585

  11. Hepatic abscess complicating ulceroglandular tularemia.

    PubMed

    Gourdeau, M; Lamothe, F; Ishak, M; Côté, J; Breton, G; Villeneuve, J P; D'Amico, P

    1983-12-15

    In a patient with the clinical features of classic ulceroglandular tularemia a solitary hepatic abscess was found during an ultrasound examination. Hepatic tularemia has rarely been reported since the advent of specific therapy, which prevents the disease from reaching the disseminated state. This case, however, shows that the liver can be involved early in the course of tularemia. Increased serum levels of hepatic enzymes may be the only sign of such a complication.

  12. Needle aspiration of peritonsillar abscess in children.

    PubMed

    Weinberg, E; Brodsky, L; Stanievich, J; Volk, M

    1993-02-01

    Needle aspiration for the treatment of peritonsillar abscess was assessed in 43 consecutive children aged 7 to 18 years (mean age, 13.9 +/- 2.5 years) during the 3-year period from 1988 through 1991. A positive aspirate was obtained in 31 (76%) of the 41 patients who cooperated for needle aspiration; a mean of 2.9 +/- 1.9 mL of pus was withdrawn. Of the 31 children with a positive aspirate, in 27 (87%) the abscess resolved, two (6%) required a second aspiration for resolution, and two (6%) underwent immediate tonsillectomy for persistent abscess. Of the 10 children (24%) with negative aspirations, in six (60%) the abscess resolved with antibiotic treatment alone, three (30%) underwent immediate (quinsy) tonsillectomy, and in one (10%) the abscess spontaneously drained. No bleeding, airway obstruction, or anesthetic complications occurred. Needle aspiration of peritonsillar abscess in children, with tonsillectomy reserved for nonresponders, appears to be an efficacious and safe method of treatment.

  13. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    PubMed Central

    Tran, C.; Even, M.; Carbonnel, M.; Preaux, F.; Isnard, F.; Rault, A.; Rouanne, M.; Ayoubi, J. M.

    2014-01-01

    We report the case of a patient who developed a vesicoovarian fistula on an endometriosis abscessed cyst. The patient presented with an advanced endometriosis stage IV complicated with a right ovarian abscessed cyst of 10 cm. A first coelioscopy with cystectomy was realized. After surgery, a voiding cystography highlighted a fistula between the ovarian abscess and the bladder. A second surgery by median laparotomy was realized with the resection of the right ovarian abscess and the resection of vesical fistula. PMID:25152819

  14. Vesicoovarian fistula on an endometriosis abscessed cyst.

    PubMed

    Tran, C; Even, M; Carbonnel, M; Preaux, F; Isnard, F; Rault, A; Rouanne, M; Ayoubi, J M

    2014-01-01

    We report the case of a patient who developed a vesicoovarian fistula on an endometriosis abscessed cyst. The patient presented with an advanced endometriosis stage IV complicated with a right ovarian abscessed cyst of 10 cm. A first coelioscopy with cystectomy was realized. After surgery, a voiding cystography highlighted a fistula between the ovarian abscess and the bladder. A second surgery by median laparotomy was realized with the resection of the right ovarian abscess and the resection of vesical fistula. PMID:25152819

  15. Bone formation within a breast abscess

    PubMed Central

    Mannu, Gurdeep Singh; Ahmed, Farid; Cunnick, Giles; Mungalsingh, Naren

    2014-01-01

    We present a rare case of osseous metaplasia in a poorly healing breast abscess. An 87-year-old woman was referred to the breast surgery clinic with a painful lump in her right breast. Initial imaging and core biopsy suggested a breast abscess. Despite several courses of antibiotics and repeated attempts at aspiration the painful lesion persisted. It was eventually surgically excised in its entirety and final histopathology showed the presence of bone formation within the abscess. The patient's symptoms subsequently resolved. To the best of our knowledge, this is the first case in the literature, of osseous metaplasia within a breast abscess in the absence of malignancy. PMID:25246453

  16. Myocardial abscess complicating healed myocardial infarction.

    PubMed Central

    Weisz, S.; Young, D. G.

    1977-01-01

    An isolated myocardial abscess due to Bacteroides fragilis developed in the scar of a myocardial infarction. Fever, chills and signs of pericarditis were the main clinical features. Mild enteritis 1 week prior to the onset of symptoms related to the abscess was the most likely cause of the bacteremia. The diagnosis was established at thoracotomy, performed because of cardiac tamponade. Thirteen other cases of isolated bacterial myocardial abscess accompanying myocardial infarction have been reported, but all the infarctions were recent. Surgical resection for a suspected myocardial abscess should be considered in view of the high mortality, largely from cardiac rupture. Images FIG. 1 PMID:861868

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

    PubMed

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

    2015-03-01

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

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

    PubMed

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

    2015-03-01

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

  19. Microbiology and Treatment of Acute Apical Abscesses

    PubMed Central

    Rôças, Isabela N.

    2013-01-01

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

  20. Spontaneous lingual abscess in an immunocompromised patient.

    PubMed

    Kettaneh, Nick; Williamson, Kelly

    2014-05-01

    Acute lingual abscess is a rare yet life-threatening clinical entity. Lingual abscess must be appropriately diagnosed and treated in the emergency department to avoid acute airway compromise. A 68-year-old woman on immunomodulatory medication for rheumatoid arthritis presented to the emergency department with left facial pain and swelling. An anterior lingual abscess was diagnosed on computed tomographic scan. The most common cause of lingual abscess is direct trauma, although immunocompromised state is a predisposing risk factor. Intravenous antibiotics are the primary treatment modality, with consideration given to adjunctive surgical drainage. We present this case to increase awareness surrounding this diagnosis among emergency physicians. Spontaneous lingual abscess should be considered in immunocompromised patients who present to the emergency department with tongue pain and edema even in the absence of lingual trauma. PMID:24332904

  1. Medical treatment of multiple streptococcal liver abscesses

    SciTech Connect

    Matlow, A.; Vellend, H.

    1983-04-01

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

  2. Nerve abscess in primary neuritic leprosy.

    PubMed

    Rai, Dheeraj; Malhotra, Hardeep Singh; Garg, Ravindra Kumar; Goel, Madhu Mati; Malhotra, Kiran Preet; Kumar, Vijay; Singh, Arun Kumar; Jain, Amita; Kohli, Neera; Singh, Shailesh Kumar

    2013-06-01

    Nerve abscess is an infrequently reported complication of leprosy. We describe a patient with a pure neuritic type of leprosy with multiple nerve abscesses, who presented with tingling and numbness in the medial aspect of his right forearm and hand. Subsequently he developed pain, redness and swelling over the medial side of his right elbow and the flexor aspect of his right wrist. High-resolution ultrasound showed diffuse thickening of the right ulnar nerve with hypoechoic texture housing a cystic lesion with internal debris suggesting an abscess, at the cubital tunnel. Histopathological examination of the pus and tissue obtained from the abscess revealed presence of granulomas with lepra bacilli. The patient responded to surgery and multidrug therapy. In conclusion, the nerve abscess as the first manifestation of leprosy is uncommon and a high index of suspicion is required to make a correct diagnosis. PMID:24171239

  3. [Endocarditis, meningitis, pneumopathy and pneumococcal cerebral abscess in an alcoholic smoker].

    PubMed

    Vandenbos, F; Roth, S; Montagne, N

    2001-10-01

    We report a case of mitral endocarditis caused by Streptococcus pneumoniae in a 43 year old man with history of alcohol abuse and cigarette smoking. The pneumococcal endocarditis was associated with pneumonia, meningitis and brain abscess. Only transesophageal echocardiography could confirm the presence of vegetation. The patient was treated medically with good results. PMID:11887774

  4. Liver Abscess Formation Following Transarterial Chemoembolization

    PubMed Central

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

    2016-01-01

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

  5. Brain

    MedlinePlus

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

  6. Abscess

    MedlinePlus

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  7. Perinephric abscess following extracorporeal shockwave lithotripsy.

    PubMed

    Pautler, Stephen E.; Vallely, John F.; Denstedt, John D.

    1998-10-01

    Since the introduction and widespread use of extracorporeal shockwave lithotripsy (SWL), various complications have been noted. Perinephric hematoma and ureteral obstruction may be anticipated by urologists as potential problems. We report the first case of perinephric abscess encountered after 17 895 SWL treatments at our institution. A 65 year old woman presented 4 months following a second SWL procedure with a perinephric abscess and was successfully treated with percutaneous drainage. A review of the English literature revealed only 3 other cases of perinephric abscess following SWL. This diagnosis should be considered in early and late presentations of flank pain following SWL.

  8. Peritonsillar Abscess in a 40-Day-Old Infant

    PubMed Central

    Lee, Soon Min; Kwon, Byoung Chul; Choi, Sung Yon; Sohn, Myung Hyun; Yoon, Choon Sik

    2006-01-01

    A peritonsillar abscess is one of the most commonly occurring deep space infections of the head and neck in adults and children. A peritonsillar abscess that appears in newborns, however, is extremely rare. The treatment of a peritonsillar abscess requires both the selection of appropriate antibiotics and the best procedure to remove the abscessed material. We report a case of a peritonsillar abscess in a 40-day-old infant who was treated with antibiotic therapy alone. PMID:16941748

  9. Radiological diagnosis of Brodie's abscess.

    PubMed

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

    2002-12-30

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

  10. Intra-Abdominal Abscess and Primary Peritonitis Caused by Streptococcus anginosus

    PubMed Central

    Terzi, Huseyin Agah; Demiray, Tayfur; Koroglu, Mehmet; Cakmak, Guner; Hakki Ciftci, Ihsan; Ozbek, Ahmet; Altindis, Mustafa

    2016-01-01

    Introduction The Streptococcus anginosus group of bacteria are low-virulence bacteria existing as commensals in the oral flora and gastrointestinal tracts of humans. S. anginosus may spread to the blood in individuals with poor oral hygiene in cases of oral infections, such as gingivitis and tooth abscesses, that develop following the loss of mucosal unity. This may lead to infections in the whole body, primarily as brain and liver abscesses. Case Presentation A 32-year-old male patient presented with complaints of nausea, vomiting, and diffuse abdominal pain. Diffuse abdominal tenderness and rebound tenderness were detected particularly in the epigastrium and right upper quadrant. Laboratory assessment revealed a leukocyte count of 20,500/mm3. Free fluid around the liver and heterogeneous areas of abscess formation in the right lateral gallbladder were revealed on abdominal computed tomography. Diffuse adhesions between the bowel and seropurulent free liquid in the abdomen were detected on surgical exploration, and a sample was taken for cultures. The patient was discharged without complications on the sixth postoperative day and his antibiotic course was completed with 4 weeks of oral treatment. We reviewed the literature for similar cases of disseminated pyogenic infections caused by the S. anginosus group. Conclusions It should be kept in mind that the oral flora bacterium S. anginosus may cause transient bacteremia and deep-seated organ abscesses in immunodeficient patients with poor oral hygiene. Such patients with intra-abdominal abscesses should be treated with antibiotics and surgery. PMID:27630763

  11. Parotid abscess: mini-pictorial essay.

    PubMed

    Viselner, G; van der Byl, G; Maira, A; Merico, V; Draghi, F

    2013-01-01

    Bacterial and viral infection of the intraparotideal and periparotideal lymph nodes, or of the glandular parenchyma, can lead to inflammatory and subsequently suppurative changes, which can result in abscess formation. Sonography allows a detailed morphological evaluation of the gland and has an important value, complementary to clinical examination, in the study of parotid inflammatory diseases. Specifically, sonography defines lesion's characteristics and, in a large number of cases, also its nature and, among the various imaging techniques, it is considered first-line imaging for the evaluation of parotid abscesses, which are characterized by hypo-anechoic lesions, with irregular margins. Color Doppler signals are peripheral to the abscess. If combined with color Doppler, sonography is important not only in diagnosis, but also in the evaluation of therapeutic efficacy and as a guide to the aspiration and drainage of abscesses. The rarity of some of these lesions led us to publish this mini-pictorial essay.

  12. Fatal thalamic abscess secondary to dental infection.

    PubMed

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

    2015-01-01

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

  13. [Splenic abscess: etiology, diagnosis and possible therapeutics].

    PubMed

    Burnier, C; Ribordy-Baudat, V; Lamy, O

    2007-10-31

    We report the case of a 28-year-old intravenous drug abuser under quadritherapy for stage C3 AIDS and with past history of infectious endocarditis. He was admitted with a diminished general condition, weight loss, progressive unbearable abdominal pain and vomiting, without fever. An inflammatory syndrome is noted and imaging reveals a voluminous splenic abscess. Conservative treatment is initiated with repetitive drainages and intravenous antibiotics. Aetiologies, diagnosis and possible therapeutics of splenic abscesses are discussed. PMID:18018950

  14. [Psoas abscess caused by Staphylococcus lugdunensis].

    PubMed

    Tamargo Delpón, María; Demelo-Rodríguez, Pablo; Cano Ballesteros, Juan Carlos; Vela de la Cruz, Laura

    2016-01-01

    Staphylococcus lugdunensis is a coagulase-negative staphylococcus of growing importance and atypical behavior. The infections caused by this microorganism are becoming more frequent, having a broader spectrum. Psoas abscesses caused by this germ are rare, with few cases reported in the literature. In this work, we present a case of a psoas abscess caused by S. lugdunensis in a patient suffering from diabetes mellitus and rheumatoid arthritis, which was treated with intravenous cloxacillin with a good outcome. PMID:27086257

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

    PubMed

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

    2012-08-01

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

  16. Nutcracker syndrome complicating with renal abscess.

    PubMed

    Yavuz, Sevgi; Ece, Aydin; Corapli, Mahmut; Ilter, Cigdem; Guven, Rufat

    2016-04-01

    The nutcracker syndrome refers to compression of left renal vein between the superior mesenteric artery and aorta. Renal abscess consists of purulent and necrotic material localised to the renal parenchyma. These two entities are extremely rare and their coincidence has not previously been described in literature. Here, we report a case of a 10-year-old girl who developed left renal abscess probably due to nutcracker syndrome.

  17. Scrotal abscess: Varied etiology, associations, and management

    PubMed Central

    Ramareddy, Raghu S.; Alladi, Anand

    2016-01-01

    Aim: To report a series of scrotal abscess, a rare problem, their etiology, and management. Materials and Methods: A retrospective study of children who presented with scrotal abscess between January 2010 and March 2015, analyzed with respect to clinical features, pathophysiology of spread and management. Results: Eight infants and a 3-year-old phenotypically male child presented with scrotal abscess as a result of abdominal pathologies which included mixed gonadal dysgenesis (MGD) [1]; three anorectal malformations with ectopic ureter [1], urethral stricture [1], and neurogenic bladder [1]; meconium peritonitis with meconium periorchitis [2], ileal atresia [1], and intra-abdominal abscess [1]; posturethroplasty for Y urethral duplication with metal stenosis [1] and idiopathic pyocele [1]. Transmission of the organism had varied routes include fallopian tube [1], urethra ejaculatory reflux [4], hematogenous [2], and the patent process of vaginalis [2]. Two of the nine required extensive evaluation for further management. Treating the predisposing pathology resolved scrotal abscesses in eight of nine patients, one of whom, required vasectomy additionally. Idiopathic pyocele responded to needle aspiration and antibiotics. Conclusion: Scrotal abscess needs a high index of suspicion for predisposing pathology, especially in infants. Laparoscopy is safe and effective in the management of the MGD and ectopic ureter. PMID:27695207

  18. Scrotal abscess: Varied etiology, associations, and management

    PubMed Central

    Ramareddy, Raghu S.; Alladi, Anand

    2016-01-01

    Aim: To report a series of scrotal abscess, a rare problem, their etiology, and management. Materials and Methods: A retrospective study of children who presented with scrotal abscess between January 2010 and March 2015, analyzed with respect to clinical features, pathophysiology of spread and management. Results: Eight infants and a 3-year-old phenotypically male child presented with scrotal abscess as a result of abdominal pathologies which included mixed gonadal dysgenesis (MGD) [1]; three anorectal malformations with ectopic ureter [1], urethral stricture [1], and neurogenic bladder [1]; meconium peritonitis with meconium periorchitis [2], ileal atresia [1], and intra-abdominal abscess [1]; posturethroplasty for Y urethral duplication with metal stenosis [1] and idiopathic pyocele [1]. Transmission of the organism had varied routes include fallopian tube [1], urethra ejaculatory reflux [4], hematogenous [2], and the patent process of vaginalis [2]. Two of the nine required extensive evaluation for further management. Treating the predisposing pathology resolved scrotal abscesses in eight of nine patients, one of whom, required vasectomy additionally. Idiopathic pyocele responded to needle aspiration and antibiotics. Conclusion: Scrotal abscess needs a high index of suspicion for predisposing pathology, especially in infants. Laparoscopy is safe and effective in the management of the MGD and ectopic ureter.

  19. Mycotic aneurysm caused by gas-forming serotype K5 Klebsiella pneumoniae.

    PubMed

    Chen, Yi-Jung; Chen, Shey-Ying; Wang, Jin-Town; Hsueh, Po-Ren

    2009-03-01

    We describe the first documented case of mycotic aneurysm caused by gas-forming serotype K5, and rmpA and iuc positive Klebsiella pneumonia with a hypermucoviscosity phenotype in a diabetic patient. The patient received ceftriaxone for one month and underwent aorto-bi-iliac grafting and inferior mesenteric artery reimplantation and recovered well.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  2. Spontaneous MRSA postcricoid abscess: a case report and literature review.

    PubMed

    Boyce, Brian J; deSilva, Brad W

    2014-11-01

    Laryngeal abscesses are rare but potentially life-threatening infections due to potential airway obstruction. Most abscesses occur in the epiglottis or preepiglottic space as a sequela of acute supraglottitis. Abscesses in the posterior larynx are extremely rare and typically due to instrumentation or trauma. Appropriate workup and management of the airway are essential for optimizing outcomes in these patients. We present an interesting case and our management of a spontaneous posterior laryngeal abscess due to methicillin-resistant Staphlococcus aureus.

  3. Complications of Catheter Drainage for Amoebic Liver Abscess

    PubMed Central

    Sharma, Navneet; Kaur, Harpreet; Kalra, Naveen; Bhalla, Ashish; Kumar, Susheel; Singh, Virendra

    2015-01-01

    Per-cutaneously inserted catheter drainage is an accepted treatment modality for a large amoebic liver abscess. Complications that can arise are; secondary infection, bleeding into the abscess cavity, inadvertent catheter misplacement into the IVC and rupture of abscess with spillage into the peritoneal cavity. We report a case of a large amoebic liver abscess that presented with complications related to per-cutaneously inserted catheter drainage. PMID:26628843

  4. Unusual case of a lung abscess

    PubMed Central

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

    2013-01-01

    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

  5. Bronchoscopic drainage of a malignant lung abscess.

    PubMed

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

    2015-04-01

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

  6. [Surgical treatment of a solitary hepatic abscess].

    PubMed

    Boĭko, V V; Tishchenko, A M; Gusak, I V; Maloshtan, A A; Skoryĭ, D I; Smachilo, R M

    2013-06-01

    Retrospective analysis of the treatment results of 120 patients, suffering solitary hepatic abscess (SHA), was conducted. The sanation methods, in accordance to technology, the treatment impact intensity and aggressiveness, may be divided on three lines: aspirational, draining and resectional. The method of sanation is selected on the background of morphological peculiarities of abscess--its sizes, by presence of sequesters, divisioning septs, dense rigid capsule, grade of periprocess. Surgical access is determined by the abscess localization, the patient's state severity, instrumental equipment of the clinic. Differentiated approach, taking into account genesis, sizes, localization and stage of its formation, constitutes a background of successful treatment of SHA. In totally formatted acute SHA, as a rule, the methods of choice are aspirational and aspiration-draining methods of sanation under ultrasonographic control or laparoscopy. In the presence of chronic SHA or suppurated parasitic hepatic cyst it is mandatory to select the resectional methods.

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

    PubMed

    Stephens, M M; MacAuley, P

    1988-09-01

    In 20 patients with 21 Brodie's abscesses, a long-term review revealed that 13 occurred in the second decade of life. All had local symptoms for six weeks or more. The tibia was involved in 11 cases and seven of these were in the proximal metaphysis. The erythrocyte sedimentation rate (ESR) was elevated in only six cases. When the ESR was more than 40 mm per hour, recurrence was more likely. Staphylococcus aureus was cultured from 11 abscesses. Curettage and antibiotics for six weeks were adequate for treatment in most cases. However, lesions larger than 3 cm in diameter should be grafted, and patients with an elevated ESR require more aggressive decompression and prolonged antibiotic therapy. Lesions within the neck of the femur pose particular anatomic problems and should not be approached laterally. All cases were followed to full bone maturity. No significant leg length inequality was clinically or roentgenologically apparent. If an abscess was juxtaphyseal, deformity of the epiphysis could develop.

  8. The Cutaneous Microbiome in Outpatients Presenting With Acute Skin Abscesses

    PubMed Central

    Horton, James M.; Gao, Zhan; Sullivan, D. Matthew; Shopsin, Bo; Perez-Perez, Guillermo I.; Blaser, Martin J.

    2015-01-01

    Background. Previous studies have demonstrated an association between antibiotic use and the development of skin abscesses. We tested the hypothesis that alterations in the composition of the cutaneous microbiota may predispose individuals to skin abscesses. Methods. We studied 25 patients with skin abscesses and 25 age-matched controls, who each completed a questionnaire. Skin swab samples were obtained for DNA analysis from 4 sites around the abscess site (hereafter, “peri-abscess specimens”) and from similar sites on the patient's contralateral side and on healthy control subjects. DNA was extracted and analyzed by quantitative polymerase chain reaction (qPCR) and high-throughput sequencing. The purulent abscess drainage was sent for culture. Results. Fifteen patients with abscess were infected with Staphylococcus aureus. Use of nuc qPCR to quantitate S. aureus revealed a significantly greater frequency of positive results for peri-abscess and contralateral skin samples, compared with control skin specimens. Analysis of community structure showed greater heterogeneity in the control samples than in the peri-abscess and contralateral samples. Metagenomic analysis detected significantly more predicted genes related to metabolic activity in the peri-abscess specimens than in the control samples. Conclusions. The peri-abscess microbiome was similar to the contralateral microbiome, but both microbiomes differed from that for control patients. Host characteristics affecting microbial populations might be important determinants of abscess risk. PMID:25583170

  9. Ruptured Liver Abscess in Neonates: Report of Two Cases

    PubMed Central

    Khan, Niyaz Ahmed; Choudhury, SR; Jhanwar, Praveen

    2016-01-01

    Neonatal hepatic abscess is a rare disease seen mainly in preterm following umbilical catheterisation. Liver abscess in term neonates without any predisposing factor is still rarer and only few cases have been reported in the literature. Here we report two cases of liver abscess in term neonates presenting with abdominal mass due to rupture. PMID:27433449

  10. [Report of 2 cases of prostatic abscess].

    PubMed

    Dakir, M; Aboutaieb, R; Dahami, Z; Sarf, I; Zamiati, W; Essakalli, N; el Mrini, M; Meziane, F; Benjelloun, S

    2000-04-01

    Prostatic abscess is a rare disease. In the light of two cases, the authors discuss the diagnostic and therapeutic aspects of this disease. Two patients, aged 17 and 55 years, presented nonspecific clinical features. Medical imaging (US, CT) established the diagnosis by showing a loculated cystic prostatic mass. Treatment consisted of transurethral drainage and antibiotics with a favourable course in both cases. Prostatic abscess is a rare disease for which the diagnosis has been facilitated by progress in medical imaging. The treatment of choice remains transurethral endoscopic drainage.

  11. Acute abdomen caused by brucellar hepatic abscess.

    PubMed

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

    2007-10-01

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

  12. Rapidly Progressive Spontaneous Spinal Epidural Abscess

    PubMed Central

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

    2016-01-01

    Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation. PMID:27688918

  13. Rapidly Progressive Spontaneous Spinal Epidural Abscess.

    PubMed

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

    2016-01-01

    Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation. PMID:27688918

  14. Rapidly Progressive Spontaneous Spinal Epidural Abscess

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2008-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  17. Orbital abscess from dacryocystitis caused by Morganella morganii.

    PubMed

    Carruth, Bryant P; Wladis, Edward J

    2013-02-01

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

  18. Falciform ligament abscess after omphalitis: report of a case.

    PubMed

    Moon, Suk-Bae; Lee, Hae Won; Park, Kwi-Won; Jung, Sung-Eun

    2010-07-01

    A falciform ligament abscess is a rare type of intra-abdominal abscess. A 2-yr-old male, who had omphalitis two months previously, presented with a fever and right upper quadrant abdominal pain. The ultrasound and CT scan showed an abdominal wall abscess located anterior to the liver, which was refractory to conservative management with percutaneous drainage and antibiotics. On the third recurrence, surgical exploration was performed and revealed an abscess arising from the falciform ligament; the falciform ligament was excised. A follow up ultrasound confirmed complete resolution of the abscess with no further recurrence.

  19. Breast abscess due to Actinomyces europaeus.

    PubMed

    Silva, W A; Pinheiro, A M; Jahns, B; Bögli-Stuber, K; Droz, S; Zimmerli, S

    2011-06-01

    Actinomyces europaeus was first described in 1997 as a new species causing predominantly skin and soft-tissue infections. Mastitis due to A. europaeus is an unusual condition. This article reports a case of primary breast abscess caused by A. europaeus in a postmenopausal woman.

  20. Recurrent abscess after MammoSite brachytherapy.

    PubMed

    Lopchinsky, Richard A; Giles, Kristina A

    2004-01-01

    Recently a new catheter was introduced to facilitate brachytherapy in a lumpectomy cavity. Data are limited on the side effects of high-dose brachytherapy to the lumpectomy cavity with the MammoSite catheter. We present a case of recurrent abscesses over a 7-month period in the lumpectomy cavity after MammoSite brachytherapy.

  1. Giant horseshoe intra-abdominal abscess.

    PubMed Central

    Altemeier, W A; Culbertson, W R; Fidler, J P

    1975-01-01

    A study of 12 patients with giant horseshoe abscess of the abdominal and pelvic cavities seen at the Surgical Services of the University of Cincinnati Medical Center has emphasized the complexity and bizarre nature of these lesions. These infections represented a huge abscess or series of communicating abscesses extending from one subphrenic space along the corresponding paracolic gutter into the pelvis, up and along the opposite paracolic space, and into the other subphrenic space. Since these lesions occurred infrequently, they were often not recognized until they had become far advanced and had produced profound effects on the patients. The diagnosis was difficult and obscured by various factors including the postoperative state after laparotomy for complex diseases or serious injuries of the biliary tract, the genitourinary tract, or the alimentary tract. An important etiologic component of the formation of these giant abscesses was the continuing escape and collection of large volumes of fluid resulting from lesions of the biliary tract, postoperative hemorrhage, or an unrecognized large perforated peptic ulcer. Nine patients were treated successfully and 3 died. The many diagnostic and therapeutic problems presented by the patients with this interesting and complex lesion have emphasized the importance of earlier and more accurate diagnosis, early and adequate surgical drainage, intelligently applied antibiotic therapy and appropriate supportive treatment. Failure to recognize and drain effectively each of the component sections of this lesion led to continuing sepsis with prolonged morbidity, progressive debility, and death. Images Fig. 1. Fig. 2. PMID:1079447

  2. Bartholin's gland abscess caused by Brucella melitensis.

    PubMed

    Peled, Neha; David, Yohai; Yagupsky, Pablo

    2004-02-01

    We report herein a case of Bartholin's gland abscess caused by Brucella melitensis. Clinical microbiology laboratory workers in areas where this disease is endemic should be familiar with the bacteriological features of this organism and consider the possibility of a brucellar etiology in a broad range of clinical settings.

  3. Calcinosis in juvenile dermatomyositis mimicking cold abscess.

    PubMed

    Nagar, Rajendra P; Bharati, Joyita; Sheriff, Abraar; Priyadarshini, Praytusha; Chumber, Sunil; Kabra, S K

    2016-01-01

    We report a case of dystrophic calcification presenting as soft cystic swelling in a patient with juvenile dermatomyositis. A 15-year-old boy with lumbosacral cystic swelling, which was considered a cold abscess clinically, was evaluated for nonresponse to antitubercular therapy. The cystic swelling had liquefied calcium with a well circumscribed calcified wall on imaging, which was subsequently excised. PMID:27586213

  4. Herpesviruses in Abscesses and Cellulitis of Endodontic Origin

    PubMed Central

    Chen, Vicky; Chen, Yanwen; Li, Hong; Kent, Karla; Baumgartner, J. Craig; Machida, Curtis A.

    2009-01-01

    Acute apical abscesses and cellulitis are severe endodontic diseases caused by opportunistic bacteria with possible co-infection with latent herpesviruses. The objectives of this study are to identify herpesviruses, including human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), herpes simplex virus-1 (HSV-1) and Varicella zoster virus (VZV), in patients (n=31) presenting with acute apical abscesses and cellulitis of endodontic origin. Primary and nested polymerase chain reaction (PCR) was conducted using virus-specific primers and DNA isolated from cell-free abscess fluid. From patients exhibiting concurrent spontaneous pain (n=28), nine abscesses contained HCMV, two abscesses contained EBV, one abscess contained HSV-1, and no abscesses contained VZV. Control PCR using genomic or recombinant templates demonstrated detection limits to a single genomic copy of HCMV, 100 genomic copies for EBV, and 1-10 copies for HSV-1, with no cross-amplification between herpesviral DNA targets. Nested PCR was required for detection of herpesviral DNA in the abscess specimens, indicating that these viruses were present in low copy number. Filtration of abscess specimens and virus transfer experiments using human fibroblastic MRC-5 cells confirmed the presence of HCMV particles in several abscess specimens. We conclude that herpesviruses are present, but not required for development of acute apical abscesses and cellulitis of endodontic origin. PMID:19166769

  5. Prognostic indications of the failure to treat amoebic liver abscesses

    PubMed Central

    Sánchez-Aguilar, Martín; Morán-Mendoza, Onofre; Herrera-Hernández, Miguel F; Hernández-Sierra, Juan Francisco; Mandeville, Peter B; Tapia-Pérez, J Humberto; Sánchez-Reyna, Martín; Sánchez-Rodríguez, José Juan; Gordillo-Moscoso, Antonio

    2012-01-01

    Objectives To identify the variables that predict the failure to treat amoebic liver abscesses. Methods We prospectively carried out a case–control study on a cohort of patients who had been diagnosed with amoebic liver abscesses using clinical, ultrasonic, and serologic methods. Patients with pyogenic abscesses, negative ELISA tests for amoebiasis, immunosuppression status, or previous abdominal surgery were excluded. All patients received metronidazole, and those who demonstrated 4 days of unfavorable clinical responses received percutaneous or surgical draining of the abscess. Demographic, laboratory, and ultrasonographic characteristics were assessed as prognostic indications of failure. Results Of 40 patients with amoebic liver abscess, 24 (mean age: 36.7±11.2 years) responded to medical treatment and 16 (41.8±11.6 years) required drainage, including 14 patients who underwent percutaneous drainage and two patients who required surgery. The albumin level, abscess volume, abscess diameter, and alkaline phosphatase level were all statistically significant (P<0.05) on the bivariate analysis. The highest (>99%) sensitivity and negative predictive value were observed for an abscess volume >500 ml and diameter >10 cm, while the best specificity and positive predictive value were achieved with the combination of low serum albumin level, high alkaline phosphatase level, and large abscess volume or diameter. Conclusions The prognostic indications of the failure to treat amoebic liver abscesses include low albumin, high alkaline phosphatase, and large abscess volume or diameter. The combination of these variables is a useful and easy tool for determining appropriate therapy. PMID:23265424

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

    SciTech Connect

    Landers, D.V.; Sweet, R.L.

    1985-04-15

    Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired.

  7. [Pasteurella multocida meningitis with cerebral abscesses].

    PubMed

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

    2014-03-01

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

  8. A fish bone-related hepatic abscess

    PubMed Central

    Jarry, Julien; Nguyen, Vien; Stoltz, Adeline; Imperato, Marc; Michel, Philippe

    2011-01-01

    We report an unusual case of pyogenic, hepatic abscess caused by fish bone penetration of the duodenum in a 68-year-old woman. The fish bone had migrated into the liver through the duodenal wall. The patient was initially admitted to our emergency room with abdominal pain, fever, and asthenia. A contrastenhanced abdominal coputed tomography (CT) scan showed a hepatic abscess in relation with a straight, foreign body, which had entered through the duodenal wall. Surgery was necessary to remove the foreign body, which was identified as a fish bone. The patient's recovery was uneventful and she was discharged on postoperative day 10. This case is discussed together with the data collected by a medline-based extensive review of the literature. PMID:24765356

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

    PubMed

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

    2011-04-01

    Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie's abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie's abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment.

  10. Scintigraphic findings in a Brodie's abscess.

    PubMed

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

    1995-10-01

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

  11. DESCENDING NECROTIZING MEDIASTINITIS SECONDARY TO RETROPHARYNGEAL ABSCESS.

    PubMed

    Kovacić, Marijan; Kovacić, Ivan; Dželalija, Boris

    2015-12-01

    Descending necrotizing mediastinitis secondary to a nontraumatic retropharyngeal abscess is very rare. This form of mediastinitis in the era of potent antibiotics often ends up with lethal outcome. It usually occurs in immunocompromised patients and requires intensive multidisciplinary treatment approach. We report a case of nontraumatic retropharyngeal abscess complicated by descending necrotizing mediastinitis in a 70-year-old man with insulin dependent diabetes mellitus. The patient was admitted to our hospital after clinical and radiological diagnosis of retropharyngeal abscess. During treatment for retropharyngeal abscess with antibiotic therapy and transoral incision, the patient showed mild clinical improvement but his condition suddenly aggravated on day 4 of hospital stay. He had high fever, chest pain with tachypnea, tachycardia, hypotension, and showed signs of occasional disorientation. Emergency computed tomography (CT) scan of the neck and thorax showed inflammation in the retropharyngeal space, as well as thickening of the upper posterior mediastinum fascia with the presence of air. Emergency surgery including cervicotomy and drainage of the retropharyngeal space and posterior mediastinum was performed. The patient promptly recovered with improvement of the clinical status and laboratory findings. After 16 days of treatment he was discharged from the hospital in good condition. Descending necrotizing mediastinitis can be a serious and life threatening complication of deep neck infection if the diagnosis is not quickly established. Besides inevitable application of antimicrobial drugs, good drainage of the mediastinum is necessary. We believe that transcervical approach can achieve high-quality drainage of the upper mediastinum, especially if it is done timely as in this case. Its efficacy can be verified by intensive monitoring of the patient clinical condition, by CT scan of the thorax, and by laboratory tests. In the case of inefficacy of this type

  12. DESCENDING NECROTIZING MEDIASTINITIS SECONDARY TO RETROPHARYNGEAL ABSCESS.

    PubMed

    Kovacić, Marijan; Kovacić, Ivan; Dželalija, Boris

    2015-12-01

    Descending necrotizing mediastinitis secondary to a nontraumatic retropharyngeal abscess is very rare. This form of mediastinitis in the era of potent antibiotics often ends up with lethal outcome. It usually occurs in immunocompromised patients and requires intensive multidisciplinary treatment approach. We report a case of nontraumatic retropharyngeal abscess complicated by descending necrotizing mediastinitis in a 70-year-old man with insulin dependent diabetes mellitus. The patient was admitted to our hospital after clinical and radiological diagnosis of retropharyngeal abscess. During treatment for retropharyngeal abscess with antibiotic therapy and transoral incision, the patient showed mild clinical improvement but his condition suddenly aggravated on day 4 of hospital stay. He had high fever, chest pain with tachypnea, tachycardia, hypotension, and showed signs of occasional disorientation. Emergency computed tomography (CT) scan of the neck and thorax showed inflammation in the retropharyngeal space, as well as thickening of the upper posterior mediastinum fascia with the presence of air. Emergency surgery including cervicotomy and drainage of the retropharyngeal space and posterior mediastinum was performed. The patient promptly recovered with improvement of the clinical status and laboratory findings. After 16 days of treatment he was discharged from the hospital in good condition. Descending necrotizing mediastinitis can be a serious and life threatening complication of deep neck infection if the diagnosis is not quickly established. Besides inevitable application of antimicrobial drugs, good drainage of the mediastinum is necessary. We believe that transcervical approach can achieve high-quality drainage of the upper mediastinum, especially if it is done timely as in this case. Its efficacy can be verified by intensive monitoring of the patient clinical condition, by CT scan of the thorax, and by laboratory tests. In the case of inefficacy of this type

  13. Melioidosis: A Rare Cause of Liver Abscess.

    PubMed

    Martin, Peter Franz M San; Teh, Catherine S C; Casupang, Ma Amornetta J

    2016-01-01

    Case Presentation. This is a case of a 44-year-old male, farmer, known to be diabetic, presenting with two-week history of vague abdominal pain associated with high grade fever. Abdominal CT scan showed localized liver abscess at segment 8 measuring 7.5 × 6.8 × 6.1 cm. Patient subsequently underwent laparoscopic ultrasound guided pigtail insertion for drainage of abscess. Culture studies showed moderate growth of Burkholderia pseudomallei in which the patient completed seven days of IV Meropenem. On follow-up after 12 weeks of oral Sulfamethoxazole/Trimethoprim, taken twice a day, the patient remained asymptomatic with no residual findings based on the abdominal ultrasound. Discussion. Diagnosis of melioidosis, a known "great masquerader," relies heavily on culture studies. Consensus with regard to the management of liver abscess caused by Burkholderia pseudomallei has not yet been established due to the rarity of cases. Surgical intervention through either a percutaneous or open drainage has shown good outcomes compared to IV antibiotics alone. In Philippines, the possibility of underreporting is highly plausible. This write-up serves not only to report a rare presentation of melioidosis but also to add to the number of cases reported in the country, possibly indicative of disease emergence. PMID:27529039

  14. Intraperitoneal tuberculous abscess: Computed tomography features

    PubMed Central

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

    2015-01-01

    AIM: To evaluate the computed tomography (CT) features of intraperitoneal tuberculous abscess (IPTA). METHODS: Eight patients with IPTA confirmed by pathology were analyzed retrospectively. The clinical symptoms, medical images, and surgical findings were evaluated. Involvement of the intestine, peritoneum, viscera, and lymph nodes was also assessed. RESULTS: All 8 patients had a history of abdominal discomfort for 1 to 6 mo. Physical examination revealed a palpable abdominal mass in 6 patients. Three patients had no evidence of pulmonary tuberculosis (TB). All IPTAs (11 abscesses) were seen as a multiseptated, peripherally enhanced, hypodense mass with enlarged, rim-enhanced lymph nodes. The largest abscess diameter ranged from 4.5 cm to 12.2 cm. CT showed 2 types of IPTA: Lymph node fusion and encapsulation. Of the 8 patients, one had liver tuberculosis and one had splenic and ovarian tuberculosis. Two cases showed involvement of the terminal ileum and ileocecal junction. Ascites were found in 4 cases. Three patients had peritonitis and mesenteritis. Three patients showed involvement of the omentum. Three patients had histological evidence of caseating granuloma, and 5 had histological evidence of acid-fast bacilli. CONCLUSION: CT is crucial in the detection and characterization of IPTA. Certain CT findings are necessary for correct diagnosis. PMID:26435779

  15. Melioidosis: A Rare Cause of Liver Abscess

    PubMed Central

    Teh, Catherine S. C.; Casupang, Ma. Amornetta J.

    2016-01-01

    Case Presentation. This is a case of a 44-year-old male, farmer, known to be diabetic, presenting with two-week history of vague abdominal pain associated with high grade fever. Abdominal CT scan showed localized liver abscess at segment 8 measuring 7.5 × 6.8 × 6.1 cm. Patient subsequently underwent laparoscopic ultrasound guided pigtail insertion for drainage of abscess. Culture studies showed moderate growth of Burkholderia pseudomallei in which the patient completed seven days of IV Meropenem. On follow-up after 12 weeks of oral Sulfamethoxazole/Trimethoprim, taken twice a day, the patient remained asymptomatic with no residual findings based on the abdominal ultrasound. Discussion. Diagnosis of melioidosis, a known “great masquerader,” relies heavily on culture studies. Consensus with regard to the management of liver abscess caused by Burkholderia pseudomallei has not yet been established due to the rarity of cases. Surgical intervention through either a percutaneous or open drainage has shown good outcomes compared to IV antibiotics alone. In Philippines, the possibility of underreporting is highly plausible. This write-up serves not only to report a rare presentation of melioidosis but also to add to the number of cases reported in the country, possibly indicative of disease emergence. PMID:27529039

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

    PubMed

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

    1996-01-01

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

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

    PubMed

    Gulati, Yash; Maheshwari, Aditya V

    2007-10-01

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

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

    PubMed

    Bagatur, A Erdem; Zorer, Gazi

    2003-03-01

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

  19. Luc abscess: an extraordinary complication of acute otitis media.

    PubMed

    Er, Anıl; Erdağ, Taner Kemal; Çağlar, Aykut; Kümüş, Özgür; Duman, Murat

    2016-01-01

    Luc abscess is an uncommon suppurative complication of otitis media. Unfamiliarity of this complication leads to delayed diagnosis and treatment. This abscess is usually benign. Infection in the middle ear spreads via anatomic preexisting pathways, and this process results with subperiosteal pus collection. Conservative treatment with drainage under empirical wide spectrum antibiotic is efficient. Here,we present a 9-year-old boy who had left facial swelling after a period of otalgia, diagnosed as Luc abscess without mastoiditis.

  20. Computed Tomography in the Diagnosis of Intra-abdominal Abscesses

    PubMed Central

    Daffner, Richard H.; Halber, Michael D.; Morgan, Carlisle L.; Trought, William S.; Thompson, William M.; Rice, Reed P.

    1979-01-01

    The diagnosis of intra-abdominal abscess by radiographic means often relies on combining the results of several different imaging modalities. Computed tomography (CT) has been shown to be a safe, accurate and rapid diagnostic method of diagnosing these abscesses. Five patients with a variety of intra-abdominal abscesses are presented in whom the CT scan alone provided the correct diagnosis. The various imaging modalities available for the radiologic diagnosis of intra-abdominal abscess are described and are compared to CT diagnosis regarding their pitfalls. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig.5.C. PMID:758860

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

    PubMed

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

    2004-09-01

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

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

    PubMed

    Izumi, Masashi; Ikeuchi, Masahiko; Tani, Toshikazu

    2012-08-01

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

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

    NASA Technical Reports Server (NTRS)

    Sato, M.

    1978-01-01

    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 lunar basalts, this reduction continues through the extrusive phase and the relative oxygen fugacity decreases rapidly until buffered by the precipitation of a metallic phase. For hydrous magmas such as terrestrial basalts, reduction by carbon is eventually superceded by oxidation due to loss of H2 generated by the reaction of C with H2O and by thermal dissociation of H2O. The relative oxygen fugacity of a hydrous magma initially decreases as a magma ascends from the source region and then increases until magnetite crystallization curbs the rising trend of the relative oxygen fugacity.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

    Several recent studies have demonstrated that virulence in Entamoeba histolytica is triggered in the presence of both pathogenic and nonpathogenic bacteria species using in vitro and in vivo experimental animal models. In this study, we examined samples aspirated from abscess material obtained from patients who were clinically diagnosed with amebic liver abscess (ALA) or pyogenic liver abscess (PLA). To determine the diversity of bacterial species in the abscesses, we performed partial 16S rRNA gene sequencing. In addition, the E. histolytica and Entamoeba dispar species were genotyped using tRNA-linked short tandem repeats as specific molecular markers. The association between clinical data and bacterial and parasite genotypes were examined through a correspondence analysis. The results showed the presence of numerous bacterial groups. These taxonomic groups constitute common members of the gut microbiota, although all of the detected bacterial species have a close phylogenetic relationship with bacterial pathogens. Furthermore, some patients clinically diagnosed with PLA and ALA were coinfected with E. dispar or E. histolytica, which suggests that the virulence of these parasites increased in the presence of bacteria. However, no specific bacterial groups were associated with this effect. Together, our results suggest a nonspecific mechanism of virulence modulation by bacteria in Entamoeba. PMID:26572872

  6. Tubo-Ovarian Abscess: Pathogenesis and Management

    PubMed Central

    Osborne, Newton G.

    1986-01-01

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

  7. Sub-Tenon's space abscess after strabismus surgery.

    PubMed

    Brenner, Christiana; Ashwin, Mallipatna; Smith, David; Blaser, Susan

    2009-04-01

    Inflammatory orbital complications of strabismus surgery are a rare occurrence. They include cellulitis, subconjunctival and sub-Tenon's abscesses, myositis, and endophthalmitis. The incidence of periocular infection is assumed to be one case per 1,100 surgeries. In this report, we describe a case of sub-Tenon's abscess after strabismus surgery.

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

    PubMed

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

    2014-03-01

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

  9. Genomewide association study of liver abscess in beef cattle

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  10. Endoscopic transmaxillary drainage of an infratemporal fossa abscess

    PubMed Central

    Sundaram, Sreetharan Sivapatha; Rajan, Philip; Balasubramanian, Anusha

    2014-01-01

    Infratemporal fossa abscess is a rare and challenging condition to diagnose and manage. A few reported cases have been mostly due to odontogenic infections and were managed by external or intraoral drainage. This is the first reported case of an infratemporal fossa abscess that was successfully managed by endoscopic drainage via a transmaxillary approach. PMID:24980993

  11. Isolation of Bordetella bronchiseptica from blood and a pancreatic abscess.

    PubMed

    Matic, Nancy A; Bunce, Paul E

    2015-05-01

    Bordetella bronchiseptica is a respiratory pathogen rarely encountered in human hosts. We describe a case of bacteremia and pancreatic abscess caused by this organism. To our knowledge, this is the first reported case of B. bronchiseptica causing intra-abdominal infection in the form of an abscess. PMID:25740781

  12. Salmonella typhi Liver Abscess Overlying a Metastatic Melanoma

    PubMed Central

    Jorge, Jannaina F.; Costa, Andressa B. V.; Rodrigues, Jorge L. N.; Girão, Evelyne S.; Luiz, Roberta S. S.; Sousa, Anastácio Q.; Moore, Sean R.; Menezes, Dalgimar B.; Leitão, Terezinha M. J. S.

    2014-01-01

    Pyogenic liver abscesses caused by Salmonella enterica serotype Typhi, although rare, can occur especially in patients with pre-existing hepatobiliary disease, hepatocellular carcinoma, and metastatic liver tumors. We present a case of Salmonella liver abscesses complicating metastatic melanoma in a 24-year-old alcoholic male. PMID:24591434

  13. [Splenic abscess after angiography. Considerations on a clinical case].

    PubMed

    Tridico, F; Panier Suffat, P; Rebecchi, F; Contessa, L; Zan, S; Caldart, M

    1995-04-01

    A case of splenic abscess in a diabetic, cardiopathic and arteriopathic 49-year-old man is reported. The abscess developed on a previous splenic infarction caused by an embolus coming from an intraventricular thrombus. The angiographic procedure was the source of bacterial contamination (Staphylococcus aureus). The patient was successfully treated with splenectomy.

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

    PubMed

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

    2008-03-01

    A rare case of Brodie's abscess of distal left tibia is presented in a child which was initially missed on clinical grounds alone. Differentiation from different bone neoplasms was done on radiological grounds. The patient was managed surgically with high dose intravenous antibiotics. Brodie's abscess is very rarely encountered in our reporting of X-rays.

  15. Isolation of Bordetella bronchiseptica from blood and a pancreatic abscess.

    PubMed

    Matic, Nancy A; Bunce, Paul E

    2015-05-01

    Bordetella bronchiseptica is a respiratory pathogen rarely encountered in human hosts. We describe a case of bacteremia and pancreatic abscess caused by this organism. To our knowledge, this is the first reported case of B. bronchiseptica causing intra-abdominal infection in the form of an abscess.

  16. Surgical management of an abdominal abscess in a Malayan tapir.

    PubMed

    Lambeth, R R; Dart, A J; Vogelnest, L; Dart, C M; Hodgson, D R

    1998-10-01

    A captive Malayan tapir was observed to have inappetence, weight loss, signs of depression, mild dehydration and diarrhoea. Haematological and serum biochemical tests showed anaemia, hypoproteinaemia, hyperfibrinogenaemia and neutrophilia with a left shift. Ultrasonic examination of the abdomen under anaesthesia revealed a well-encapsulated abscess. The abscess was marsupialised to the ventral body wall. Culture of the pus produced a mixed bacterial growth. Antimicrobial therapy was based on bacterial sensitivity results. Follow-up ultrasonic examinations showed resolution of the abscess. Ninety-one days after surgery the tapir began regurgitating food and water. An abscess originating from the stomach and occluding the lumen of the duodenum was identified at surgery. The abscess ruptured during surgical manipulations and the tapir was euthanased.

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

    PubMed Central

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

    2013-01-01

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

  18. Cerebral Phaeohyphomycosis: A Rare Cause of Brain Abscess

    PubMed Central

    Jung, Na-Young

    2014-01-01

    Cerebral phaeohyphomycosis (CP) is a very rare but serious form of central nervous system fungal infection that is caused by dematiaceous fungi. It is commonly associated with poor prognosis irrespective of the immune status of the patient. In this study, the authors describe the first case of CP in Korea that occurred in a 75-year-old man without immunodeficiency and showed favorable outcome after surgical excision and antifungal therapy. In addition, the authors herein review the literature regarding characteristics of this rare clinical entity with previously reported cases. PMID:25535526

  19. Nontraumatic retropharyngeal abscess complicated by cervical osteomyelitis and epidural abscess in post-Katrina New Orleans: four cases.

    PubMed

    Faruqui, S; Palacios, Enrique; Friedlander, Paul; Melgar, Miguel; Alvernia, Jorge; Parry, Phillip Vaughan

    2009-07-01

    Most retropharyngeal abscesses, including iatrogenic cases, are caused by trauma. Nontraumatic retropharyngeal abscesses usually occur secondary to infection of the retropharyngeal lymph nodes. Because these particular nodes usually disappear by the age of 4 or 5 years, a nontraumatic retropharyngeal abscess in an adult is extremely rare. When they do occur in adults, they are generally seen in immunocompromised patients and in intravenous drug abusers. Left untreated, a retropharyngeal abscess can lead to rare and fatal complications such as cervical osteomyelitis, epidural abscess, and discitis. Retropharyngeal abscesses can be diagnosed with a thorough history of risk factors, an examination for neurologic deficits, and radiologic studies, particularly magnetic resonance imaging. Treatment involves intravenous antibiotic therapy and surgical drainage. During follow-up, it is important to closely monitor the results of clinical neurologic examinations and weekly determinations of the C-reactive protein level and erythrocyte sedimentation rate in order to assess the response to therapy. We report 4 cases of nontraumatic retropharyngeal abscess complicated by cervical osteomyelitis and epidural abscess that were seen in New Orleans within 3 years of Hurricane Katrina, which struck the U.S. Gulf Coast in August 2005.

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

    PubMed

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

    2016-01-01

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

  1. PYOGENIC LIVER ABSCESS: DIAGNOSTIC AND THERAPEUTIC MANAGEMENT

    PubMed Central

    dos SANTOS-ROSA, Otto Mauro; LUNARDELLI, Henrique Simonsen; RIBEIRO-JUNIOR, Marcelo Augusto Fontenelle

    2016-01-01

    ABSTRACT Background: The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Aim: Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Method: Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. Results: The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. Conclusion: The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource. PMID:27759785

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Clark, Christine M.; Huntley, Colin

    2016-01-01

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

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

    PubMed Central

    Clark, Christine M.; Huntley, Colin

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  6. Cerebral Abscess Presenting as a Complex Febrile Seizure.

    PubMed

    Anand, Anjoli; Salas, Alicia; Mahl, Evan; Levine, Marla C

    2015-07-01

    Currently, there is no standardized approach to the management of complex febrile seizures in children and there are no published practice guidelines for the procurement of neuroimaging. Presented is a 2-year-old female patient who experienced a 3- to 5-minute episode of staring and unilateral mouth twitching associated with high fever. On initial presentation, the patient appeared well and had a normal neurological examination. No focus of infection was identified, and she was diagnosed with complex febrile seizure. The patient was discharged home with close neurology and primary care follow-up but returned the following day with altered mental status, toxic appearance, and right lower extremity weakness. Magnetic resonance imaging of the brain revealed left-sided cranial empyema and the patient was managed with antibiotics and surgical drainage. A literature review to answer the question "Do children with complex febrile seizures require emergent neuroimaging?" yielded a small number of retrospective reviews describing the utility of computed tomography, magnetic resonance imaging and lumbar puncture in the work-up of febrile seizures. Current evidence indicates that neuroimaging is not indicated in an otherwise healthy child who presents with complex febrile seizure if the patient is well appearing and has no evidence of focal neurological deficit on examination. As this case demonstrates, however, serious conditions such as meningitis and brain abscess (though rare) should be considered in the differential diagnosis of complex febrile seizure and physicians should remain aware that the need for neuroimaging and/or lumbar puncture may arise in the appropriate clinical setting.

  7. Cerebral Abscess Presenting as a Complex Febrile Seizure.

    PubMed

    Anand, Anjoli; Salas, Alicia; Mahl, Evan; Levine, Marla C

    2015-07-01

    Currently, there is no standardized approach to the management of complex febrile seizures in children and there are no published practice guidelines for the procurement of neuroimaging. Presented is a 2-year-old female patient who experienced a 3- to 5-minute episode of staring and unilateral mouth twitching associated with high fever. On initial presentation, the patient appeared well and had a normal neurological examination. No focus of infection was identified, and she was diagnosed with complex febrile seizure. The patient was discharged home with close neurology and primary care follow-up but returned the following day with altered mental status, toxic appearance, and right lower extremity weakness. Magnetic resonance imaging of the brain revealed left-sided cranial empyema and the patient was managed with antibiotics and surgical drainage. A literature review to answer the question "Do children with complex febrile seizures require emergent neuroimaging?" yielded a small number of retrospective reviews describing the utility of computed tomography, magnetic resonance imaging and lumbar puncture in the work-up of febrile seizures. Current evidence indicates that neuroimaging is not indicated in an otherwise healthy child who presents with complex febrile seizure if the patient is well appearing and has no evidence of focal neurological deficit on examination. As this case demonstrates, however, serious conditions such as meningitis and brain abscess (though rare) should be considered in the differential diagnosis of complex febrile seizure and physicians should remain aware that the need for neuroimaging and/or lumbar puncture may arise in the appropriate clinical setting. PMID:26151351

  8. Tuberculosis as an Etiological Factor in Liver Abscess in Adults

    PubMed Central

    Dey, Jaideep; Venugopal, Shwetha; Mirdha, Bijay Ranjan

    2016-01-01

    Background. Tuberculosis of the liver without active pulmonary or miliary tuberculosis is considered as an uncommon diagnosis. The aim of the present study was to determine the etiological role of tuberculosis in adult patients presenting with features of liver abscess. Methods. A total of 40 patients with liver abscess were included in the study. The liver abscess aspirate was subjected to microscopy, culture, and polymerase chain reaction to determine the role of tuberculosis as an etiological factor in liver abscess. Results. Of the 40 patients enrolled, 25% (10/40) were diagnosed with having tubercular liver abscess. In a total of 40 specimens, 2.5% (1/40) were positive for acid fast bacilli by Ziehl-Neelsen method, while 10% (4/40) were positive for M. tuberculosis by culture using BACTEC 460 and the yield increased to 25% (10/40) by polymerase chain reaction for M. tuberculosis. Conclusion. 25% of the patients presenting with liver abscess had tubercular etiology without features of active pulmonary or miliary tuberculosis. Liver can act as the primary site of involvement in the absence of activity elsewhere in the body. Tuberculosis should be considered as an important differential diagnosis of liver abscess irrespective of evidence of active tuberculosis elsewhere in the body. PMID:27595021

  9. Tuberculosis as an Etiological Factor in Liver Abscess in Adults.

    PubMed

    Dey, Jaideep; Gautam, Hitender; Venugopal, Shwetha; Porwal, Chhavi; Mirdha, Bijay Ranjan; Gupta, Naresh; Singh, Urvashi B

    2016-01-01

    Background. Tuberculosis of the liver without active pulmonary or miliary tuberculosis is considered as an uncommon diagnosis. The aim of the present study was to determine the etiological role of tuberculosis in adult patients presenting with features of liver abscess. Methods. A total of 40 patients with liver abscess were included in the study. The liver abscess aspirate was subjected to microscopy, culture, and polymerase chain reaction to determine the role of tuberculosis as an etiological factor in liver abscess. Results. Of the 40 patients enrolled, 25% (10/40) were diagnosed with having tubercular liver abscess. In a total of 40 specimens, 2.5% (1/40) were positive for acid fast bacilli by Ziehl-Neelsen method, while 10% (4/40) were positive for M. tuberculosis by culture using BACTEC 460 and the yield increased to 25% (10/40) by polymerase chain reaction for M. tuberculosis. Conclusion. 25% of the patients presenting with liver abscess had tubercular etiology without features of active pulmonary or miliary tuberculosis. Liver can act as the primary site of involvement in the absence of activity elsewhere in the body. Tuberculosis should be considered as an important differential diagnosis of liver abscess irrespective of evidence of active tuberculosis elsewhere in the body. PMID:27595021

  10. Oral microbiota species in acute apical endodontic abscesses

    PubMed Central

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

    2016-01-01

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

  11. Neutrophil localization in acute and chronic experimental abscesses

    SciTech Connect

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

    1987-04-01

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

  12. Long-term survival in a dog with meningoencephalitis and epidural abscessation due to Actinomyces species.

    PubMed

    Song, Rachel B; Vitullo, Carina A; da Costa, Ronaldo C; Daniels, Joshua B

    2015-07-01

    A 2-year-old, female spayed Golden Retriever dog was presented to The Ohio State University Veterinary Medical Center for evaluation of ataxia, cervical pain, 1 episode of acute collapse, dull mentation, and inappetence. Physical examination revealed an elevated temperature of 39.7°C and severe cervical pain. Blood work revealed a mature neutrophilia. Cerebrospinal fluid (CSF) analysis revealed nondegenerative neutrophilic pleocytosis with no infectious agents. A presumptive diagnosis of steroid-responsive meningitis-arteritis was made, and corticosteroid therapy was started. The patient improved initially but experienced a vestibular episode characterized by falling and vertical nystagmus. A magnetic resonance imaging of the brain revealed an epidural abscess in the cervical vertebral canal and diffuse meningeal enhancement in the brain and cranial cervical spine. Abscess drainage revealed degenerate neutrophils and several filamentous, branching organisms. Culture of the initial CSF using an enrichment broth revealed growth of a Gram-positive organism 5 days after fluid collection. The isolate was identified by partial 16S ribosomal DNA sequencing as Actinomyces spp. The patient was successfully treated with long-term antibiotics. Our study reports the long-term survival after medical treatment of bacterial meningoencephalitis and epidural abscessation due to Actinomyces sp. infection in a dog. Bacterial meningoencephalitis should be included as a differential diagnosis in patients with cervical pain and fever, even when a nondegenerative neutrophilic pleocytosis is found on CSF analysis. Culture of the CSF with use of an enrichment broth should be considered in all cases of neutrophilic pleocytosis to rule out infections of the central nervous system.

  13. Scrotal abscess, a rare case of extra intestinal amoebiasis.

    PubMed

    Prasetyo, R H

    2015-09-01

    The majority of amoeba infection are asymptomatic, but clinically intestinal amoebiasis or extra intestinal amoebiasis may result. Genital amoebiasis is very rare manifestation of extra intestial amoebiasis, but a case of amoebic scrotal abscess, seen in Surabaya. The invasive form of Entamoeba histolytica trophozoite was seen in Giemsa stained aspirate of the abscess. In case of an abscess bacteria are primarly considered, but the case presented here shows that amoeba can be the cause, although very rarely. Thus when bacteriological diagnostics are negative amoeba should be considered, especially in case of brown-reddish colored and foul smelling pus. PMID:26695210

  14. Renal abscess with Morganella morganii complicating leukemoid reaction.

    PubMed

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

    2008-01-01

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

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

    PubMed

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

    2008-04-01

    Osteomyelitis caused by Salmonella typhi is rare in patients with no haemoglobinopathies or other diseases causing immunosuppression. Brodie's abscess is a special variety of subacute or chronic osteomyelitis. An otherwise healthy woman who presented with forearm swelling for 6 months was diagnosed with a Brodie's abscess of the ulna caused by Salmonella typhi. Magnetic resonance imaging and a computed tomography-guided needle biopsy were performed. She was later found to be a Salmonella carrier. The Brodie's abscess was treated by surgical debridement and a course of antibiotics. The clinical, radiological, and management aspects of the disease are discussed.

  16. [Tibial abscess caused by histoplasma capsulatum].

    PubMed

    de Fernández, M I; Negroni, R; Arechavala, A

    2001-01-01

    Disseminated histoplasmosis is the most serious form of the disease produced by the fungus Histoplasma capsulatum. Histoplasmosis was first described by Darling in 1906, and it is endemic in certain areas of Central and Southeastern regions of USA, and most Latin America countries, including the Pampa húmeda and Mesopotamia regions in Argentina, but in other continents it has a limited regional distribution. Lung involvement predominates in 90% of cases, but H. capsulatum may involve bone and soft tissues. Bone lesions without other signs of infection are very rare, and are often misdiagnosed as cancer. We report a case of disseminated histoplasmosis in a man with a myelodysplasia who presented a left tibial abscess, without any clinical evidence of pulmonary involvement. The patient was successfully treated with itraconazole.

  17. Cervical epidural abscess caused by brucellosis.

    PubMed

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

    2012-01-01

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

  18. Salmonella Typhi Vertebral Osteomyelitis and Epidural Abscess

    PubMed Central

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

    2016-01-01

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

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

    SciTech Connect

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

    1990-06-01

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

  20. [Percutaneous treatment of abscess of the kidney and retroperitoneum].

    PubMed

    Hélénon, O; Cornud, F; Di Stéfano, D; Chiche, J F; Chrétien, Y; Moreau, J F; Dufour, B

    1989-10-01

    Twenty eight abscesses or infected liquid collections located in the kidney or in the retroperitoneum were drained percutaneously. The abscesses were located in the renal parenchyma in most cases (14 cases), in the anterior pararenal space in 3 cases and in the iliopsoas muscle in 9 cases. In all cases, the drain was inserted under TV monitoring after needle puncture, which was most often guided by ultrasound. The percutaneous treatment was successful in 82% of all cases. Among the 5 unsuccessful attempts, 1 case of duodenal fistula required surgical treatment while the anterior pararenal abscess was effectively evacuated by the inserted drain, and 1 case of infected hydatid cyst was treated surgically immediately after the percutaneous needle puncture. Drainage is the first-line method for the treatment of abscesse of the kidney and retroperitoneum. It requires an appropriate technique and strict follow-up, which allow healing the lesion in most cases.

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

    PubMed

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

    2012-01-01

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

  2. Ultrasound-guided needle aspiration of amoebic liver abscess.

    PubMed Central

    Ramani, A.; Ramani, R.; Kumar, M. S.; Lakhkar, B. N.; Kundaje, G. N.

    1993-01-01

    This prospective study was carried out on 200 patients with clinically, ultrasonographically and serologically confirmed amoebic liver abscess. The role of ultrasound-guided needle aspiration in addition to medications was evaluated compared to drug treatment alone. Both the groups were monitored clinically and sonographically for up to 6 months after diagnosis. The initial response (after 15 days) was better in the aspirated group (P < 0.05) but resolution of abscess after 6 months were similar. There was a more rapid clinical response in the aspirated group, particularly in those with larger (> 6 cm) abscesses and there were no complications. Percutaneous ultrasound-guided needle aspiration is a safe diagnostic and therapeutic approach which enhances clinical recovery, accelerates resolution, especially in large abscesses, and prevents complications. PMID:8346134

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

    PubMed

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

    2015-01-01

    Acute cholangitis secondary to ascariasis is rare and occurs mainly in areas of high endemicity. The clinical presentation is non-specific, sometimes complicated by liver abscess. Abdominal ultrasound plays an important role in diagnosis and therapeutic surveillance. We report the case of a 35-year-old Malagasy woman with an acute cholangitis secondary to ascariasis and complicated by liver abscesses and its course to full recovery under medical treatment. PMID:26742557

  4. Myopericarditis associated with Fusobacterium nucleatum-caused liver abscess.

    PubMed

    Kearney, Alexis; Knoll, Bettina

    2015-03-01

    A wide clinical spectrum of bacteremic disease caused by Fusobacterium has been presented in this journal. We wish to extend this spectrum by presenting a case of myopericarditis resulting from a liver abscess caused by F. nucleatum. While F. nucleatum plays an important role in periodontal disease, and has been isolated from skin ulcers, liver abscesses, urinary tract infections, and endocarditis, a single case of F. nucleatum-induced pericarditis is documented in the literature.

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

    PubMed Central

    Dang-Tran, Kim-Diêp; Chabbert, Valérie; Esposito, Laure; Guilbeau-Frugier, Céline; Dédouit, Fabrice; Rostaing, Lionel; Rousseau, Hervé; Otal, Phillippe; Kamar, Nassim

    2014-01-01

    Cardiac abscess is an uncommon and fatal complication after transplantation. We report a case of an initially isolated aspergillosis myocardial abscess diagnosed by cardiac magnetic resonance imaging (CMRI). At that time, there was no other biological evidence or other extracardiac manifestations. A three-month course of dual antifungal therapy followed by a single antifungal therapy was empirically given. Six month after admission, Aspergillus fumigatus was isolated for the first time and the patient deceased from a disseminated aspergillosis. PMID:24707433

  6. The Evolving Nature of Hepatic Abscess: A Review

    PubMed Central

    Mavilia, Marianna G.; Molina, Marco; Wu, George Y.

    2016-01-01

    Abstract Hepatic abscess (HA) remains a serious and often difficult to diagnose problem. HAs can be divided into three main categories based on the underlying conditions: infectious, malignant, and iatrogenic. Infectious abscesses include those secondary to direct extension from local infection, systemic bacteremia, and intra-abdominal infections that seed the portal system. However, over the years, the etiologies and risks factors for HA have continued to evolve. Prompt recognition is important for instituting effective management and obtaining good outcomes. PMID:27350946

  7. Ultrasound detection of a subperiosteal abscess secondary to coalescent otomastoiditis.

    PubMed

    Grant, R L; Piotto, L

    2005-08-01

    We report the unusual ultrasound appearance of coalescent otomastoiditis with subperiosteal abscess in a 3-month-old boy with a 1-week history of an enlarging lump behind the left ear. Ultrasound examination of the lump revealed subcutaneous oedema with an abscess extending from a defect in the cranial vault as a result of extension of the inflammatory process. We believe that this sonographic appearance has not been previously described in the published literature.

  8. Hypocholesterolemia in Patients with an Amebic Liver Abscess

    PubMed Central

    Flores, María S.; Obregón-Cárdenas, Adriana; Tamez, Eva; Rodríguez, Elba; Arévalo, Katiushka; Quintero, Isela; Tijerina, Rolando; Bosques, Francisco; Galán, Luis

    2014-01-01

    Background/Aims Many parasites induce changes in the lipid profiles of the host. Cholesterol increases the virulence of Entamoeba histolytica in animal models and in vitro culture. This study aimed to determine, in patients with an amebic liver abscess, the correlation between cholesterol and other features, such as the size and number of abscesses, standard hematological and serum chemistry profiles, liver tests, and duration of hospital stay. Methods A total of 108 patients with an amebic liver abscess and 140 clinically healthy volunteers were investigated. Cholesterol and triglycerides were measured in the sera. The data from medical observations and laboratory tests were obtained from the clinical records. Results A total of 93% of patients with an amebic liver abscess showed hypocholesterolemia not related to any of the studied parameters. Liver function tests correlated with the size of the abscess. The most severe cases of amebic liver disease or death were found in patients whose cholesterol levels continued to decrease despite receiving antiamebic treatment and hospital care. Conclusions Our results show that the hypocholesterolemia observed in patients with an amebic liver abscess is not related to any of the clinical and laboratory features analyzed. This is the first study relating hypocholesterolemia to severity of hepatic amebiasis. PMID:25071907

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

    PubMed Central

    Karagiannis, Apostolos K A; Dimitropoulou, Fotini; Papatheodorou, Athanasios; Lyra, Stavroula; Seretis, Andreas

    2016-01-01

    Summary Pituitary abscess is a rare life-threating entity that is usually misdiagnosed as a pituitary tumor with a definite diagnosis only made postoperatively. Over the last several decades, advances in healthcare have led to a significant decrease in morbidity and mortality due to pituitary abscess. We report a case of a 34-year-old woman who was admitted to our department for investigation of a pituitary mass and with symptoms of pituitary dysfunction, headaches and impaired vision. During her admission, she developed meningitis-like symptoms and was treated with antibiotics. She eventually underwent transsphenoidal surgery for excision of the pituitary mass. A significant amount of pus was evident intraoperatively; however, no pathogen was isolated. Six months later, the patient was well and had full recovery of the anterior pituitary function. Her menses returned, and she was only on treatment with desmopressin for diabetes insipidus that developed postoperatively. Learning points Pituitary abscess is a rare disease and the reported clinical features vary mimicking other pituitary lesions. The diagnosis of pituitary abscess is often very difficult to make and rarely included in the differential. The histological findings of acute inflammatory infiltration confirm the diagnosis of pituitary abscess. Medical and surgical treatment is usually recommended upon diagnosis of a pituitary abscess. PMID:27274845

  10. Community-Acquired Methicillin-Resistant Pyogenic Liver Abscess

    PubMed Central

    Cherian, Joel; Singh, Rahul; Varma, Muralidhar; Vidyasagar, Sudha; Mukhopadhyay, Chiranjay

    2016-01-01

    Pyogenic liver abscesses are rare with an incidence of 0.5% to 0.8% and are mostly due to hepatobiliary causes (40% to 60%). Most are polymicrobial with less than 10% being caused by Staphylococcus aureus. Of these, few are caused by methicillin-resistant Staphylococcus aureus (MRSA) and fewer still by a community-acquired strain. Here we present a case study of a patient with a community-acquired MRSA liver abscess. The patient presented with fever since 1 month and tender hepatomegaly. Blood tests revealed elevated levels of alkaline phosphatase, C-reactive protein, erythrocyte sedimentation rate, and neutrophilic leukocytosis. Blood cultures were sterile. Ultrasound of the abdomen showed multiple abscesses, from which pus was drained and MRSA isolated. Computed tomography of the abdomen did not show any source of infection, and an amebic serology was negative. The patient was started on vancomycin for 2 weeks, following which he became afebrile and was discharged on oral linezolid for 4 more weeks. Normally a liver abscess is treated empirically with ceftriaxone for pyogenic liver abscess and metronidazole for amebic liver abscess. However, if the patient has risk factors for a Staphylococcal infection, it is imperative that antibiotics covering gram-positive organisms be added while waiting for culture reports. PMID:27540556

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

    PubMed

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

    2014-02-05

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

  12. A mistaken identity: rhabdomyosarcoma of the middle ear cleft misdiagnosed as chronic suppurative otitis media with temporal lobe abscess

    PubMed Central

    Muranjan, Mamta; Karande, Sunil; Parikh, Shefali; Sankhe, Shilpa

    2014-01-01

    A 5-year-old girl presented with a 3-month history of left side facial palsy, followed sequentially by purulent ear discharge, complete external ophthalmoplaegia and blurred vision. On clinical examination she was febrile with left-sided conductive hearing loss. She was clinically diagnosed to have chronic suppurative otitis media of the unsafe type with petrous apicitis, middle cranial fossa abscess and cavernous sinus involvement. Preliminary CT scan findings were reported as a large left temporal lobe abscess and left otitis media with cholesteatoma. MRI of the brain obtained later corroborated the abnormalities detected on the CT scan. Ten days after admission, a mass was seen protruding from the external auditory canal. A biopsy of the mass was obtained and sent for histopathological examination. Meanwhile, review of the MRI suggested an aggressive neoplasm such as sarcoma/rhabdomyosarcoma. Histopathology clinched the final diagnosis of an anaplastic type of embryonal rhabdomyosarcoma of the middle ear cleft. PMID:25240007

  13. Nasal septal abscess complicated with acute sinusitis and facial cellulitis in a child.

    PubMed

    Lin, I-H; Huang, I-S

    2007-06-01

    Non-traumatic nasal septal abscess is rare, commonly seen in patients with poor immunity, and presents as isolated nasal septal abscess. Further, nasal septal abscess complicated with acute sinusitis is rather rare. Very little literature has been generated for non-traumatic nasal septal abscess complicated with acute sinusitis in healthy patients. Prompt diagnosis and adequate treatment will help to prevent the complications associated with nasal septal abscess such as saddle nose and intracranial involvement. Herein, to our knowledge, we present the first case involving an otherwise healthy little girl with nasal septal abscess complicated with acute sinusitis and facial cellulitis.

  14. Amoebic liver abscess production by Entamoeba dispar.

    PubMed

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

    2012-01-01

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

  15. Tuberculous abscess on the chest wall.

    PubMed

    Aylk, S; Qakan, A; Aslankara, N; Ozsöz, A

    2009-03-01

    A 58-year old patient on dialysis for four years due to chronic renal failure presented with complaints of painless, continuously growing swelling on the left of his back and coughing, symptoms evolving over a period of approximately 3 months. Physical examination revealed a soft fixed mass of 10 x 10 x 4 cm on the left infrascapular area on the chest wall. The sample taken from the inflammation on the chest wall was analyzed with PCR method which resulted positive for Acid Fast Bacilli (AFB), tissue biopsy showed dermatitis with granulomata and sputum was positive for AFB. Thoracic MR, performed for the purpose of detecting the relationship between the lesion on the lung and the one on the chest wall, detected changes in the inflammatory soft tissues and multiple small abscess formations on the chest wall. There was no pathological signal in the bone structures of the chest wall. This case underlines the necessity to include "Empyema necessitatis" in the preliminary diagnosis when there is a soft tissue swelling on the chest wall without inflammatory signs in patients with reduced immune defences.

  16. Epidural infection: Is it really an abscess?

    PubMed Central

    Avilucea, Frank R.; Patel, Alpesh A.

    2012-01-01

    Background: We reviewed the literature regarding the pathogenesis, clinical presentation, diagnosis, and management of spinal epidural abscess (SEA). Methods: Utilizing PubMed, we performed a comprehensive review of the literature on SEAs. Results: SEA remains a difficult infectious process to diagnose. This is particularly true in the early stages, when patients remain neurologically intact, and before the classic triad of fever, back pain, and neurologic deficit develop. However, knowledge of risk factors, obtaining serologic markers, and employing magnetic resonance scans facilitate obtaining a prompt and accurate diagnosis. In patients without neurologic deficits, lone medical therapy may prove effective. Conclusions: More prevalent over the previous three decades, SEA remains a rare but deleterious infectious process requiring prompt identification and treatment. Historically, identification of SEA is often elusive, diagnosis is delayed, and clinicians contend that surgical debridement is the cornerstone of treatment. Early surgery leads to more favorable outcomes and preserves neurologic function, particularly in the early stages of disease when minimal or no neurologic deficits are present. The advent of improved imaging modalities, diagnostic techniques, and multidrug antimicrobial agents has enabled medical/spinal surgical consultants to more rapidly diagnose SEA and institute more effective early medical treatment (e.g., data suggest that lone medical therapy may prove effective in the early management of SEA). PMID:23248757

  17. Appendectomy correlates with increased risk of pyogenic liver abscess

    PubMed Central

    Liao, Kuan-Fu; Lai, Shih-Wei; Lin, Cheng-Li; Chien, Sou-Hsin

    2016-01-01

    Abstract Little is known on the association between appendectomy and pyogenic liver abscess. The objective of this study was to investigate the association between appendectomy and the risk of pyogenic liver abscess in Taiwan. This population-based retrospective cohort study was conducted using the hospitalization dataset of the Taiwan National Health Insurance Program. There were 212,530 subjects age 20 to 84 years with newly diagnosed appendectomy as the appendectomy group since 1998 to 2010, and 850,099 randomly selected subjects without appendectomy as the nonappendectomy group. Both appendectomy and nonappendectomy groups were matched with sex, age, comorbidities, and index year of diagnosing appendectomy. The incidence of pyogenic liver abscess at the end of 2011 was estimated in both groups. The multivariable Cox proportional hazards regression model was applied to investigate the hazard ratio (HR) and 95% confidence interval (CI) for risk of pyogenic liver abscess associated with appendectomy and other comorbidities including alcoholism, biliary stone, chronic kidney disease, chronic liver diseases, and diabetes mellitus. The overall incidence of pyogenic liver abscess was 1.73-fold greater in the appendectomy group than that in the nonappendectomy group (3.85 vs 2.22 per 10,000 person-years, 95% CI 1.71, 1.76). The multivariable regression analysis disclosed that the adjusted HR of pyogenic liver abscess was 1.77 for the appendectomy group (95% CI 1.59, 1.97), when compared with the nonappendectomy group. Appendectomy is associated with increased hazard of pyogenic liver abscess. Further studies remain necessary to confirm our findings. PMID:27368018

  18. Iliopsoas Abscess (together with Bullet) Resulting from a Firearms Injury

    PubMed Central

    Güzel, Yunus; Çiftçi, Sadettin; Özdemir, Ali; Acar, Mehmet Ali

    2015-01-01

    Psoas abscess, which is a rarely encountered infection, is defined as the accumulation of suppurative fluid within the fascia surrounding the psoas and iliac muscles. It is categorised as being primary or secondary. Although there are reports in the literature of secondary psoas abscess from foreign bodies, to the best of our knowledge, this is the first reported case of psoas abscess developing due to a bullet, following a firearms injury. The patient was first seen in the Emergency Department following a firearms injury in the posterolateral lumbar region and as the neurovascular examination was normal, the patient was discharged after 24 hours of observation. One month later, the patient presented again to the polyclinic with a high temperature and back pain. As a result of physical examination and tests, a diagnosis was made of psoas abscess and percutaneous drainage was applied under ultrasonography guidance. The complaints improved but, 10 days later with an increase in pain and indications of infection, open abscess drainage was applied and the bullet was removed. At the 6-month follow-up examination, the patient had no complaints. PMID:26075128

  19. Splenic abscess owing to cancer at the splenic flexure

    PubMed Central

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

    2016-01-01

    Abstract Background: The cancer of the splenic flexure of the colon is a rare medical entity with severe morbidity because of its insidious onset. Methods: We present the case of a 59-year-old male patient with dull left upper quadrant pain, leukocytosis, and anemia. A splenic abscess described as an air-fluid level with splenocolic fistula was found on CT scan imaging. Surgery was done for splenic pus drainage. He was again admitted 2 months later for intestinal obstruction. Results: An exploratory laparotomy showed multiple hard, gray liver nodules as well as a hard mass in the small bowel. Owing to extensive adhesions and a late stage of cancer involvement, the splenic flexure tumor was not resected. A loop transverse colostomy was done and a ColoplastTM Colostomy bag placed. We also reviewed the literature-linking colon cancer and splenic abscess with specific attention to the carcinoma of the splenic flexure. As the latter invades through the spleen matter, there is the creation of a splenocolic fistula, which allows the migration of normal gut flora into the spleen. This leads to the formation of the splenic abscess. Conclusion: This is the 13th case report pertaining to invading colonic cancer causing a splenic abscess. Although the treatment for splenic abscesses is shifting from splenectomy to image-guided percutaneous pus drainage, the few reported cases make the proper management of such complication still unclear. PMID:27661050

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Stewart, I E; Borland, C

    1994-09-01

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

  3. [Cerebellar abscess due to infection with the anaerobic bacteria fusobacterium nucleatum: a case report].

    PubMed

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

    2015-02-01

    We report a rare case of cerebellar abscess produced by anaerobic bacteria. A 76-year-old man was admitted to our hospital with a history of fever, vomiting, and dizziness lasting 14 days. Computed tomography(CT)scan and magnetic resonance images showed the presence of a multiloculated cerebellar abscess with a right subdural abscess. The patient underwent aspiration of the abscess through a suboccipital craniotomy. Fusobacterium nucleatum, which is an anaerobic bacteria naturally present in the human oral cavity, was detected in cultures of the aspirated abscess. The patient was administered antibiotic treatment combined with hyperbaric oxygen therapy(HBO). The symptoms were briefly relieved but the cerebellar abscess recurred, which required a second aspiration. The combined treatment with antibiotics and HBO was maintained after the second operation. After 6 weeks of treatment, the cerebellar abscess was completely controlled. We conclude that antibiotic treatment combined with HBO is useful for treatment of cerebellar abscesses caused by infection with anaerobic bacteria.

  4. [Puncture-drainage sanation of abdominal abscesses: is it sufficient treatment?].

    PubMed

    Shanturov, V A; Kogan, A S; Boĭko, T N; Gumerov, R R; Fadeeva, T V; Grigor'ev, E G

    2000-01-01

    Some anatomical grounds of postoperative extravisceral abscess formation, methods and results of their treatment, therapeutic policy in abscesses of parenchymatous organs are presented. 681 patients with abdominal abscess of various location were examined. Detailed analysis of ultrasonic and computed tomographic semiotics of postoperative extravisceral suppurative focus was carried out in 164 patients. The risk zones of extravisceral abscess formation in the conditions of changed visceral syntopy and destroyed ligamentic structures were determined. The efficiency of puncture-drainage treatment in different variants of subdiaphragmatic abscess was 89.4%, in abscess of omental bursa--83.3%. Intracavital prolonged proteolysis by immobilized proteinases (imosimase) was applied. The injection of imosimase in abscess cavity led to its content lysis, including the thick products of inflammation, improving their secretion through the drainage. In the majority of the patients, the puncture-drainage treatment of abscesses of various etiology and pathogenesis is an adequate method of sanation.

  5. Lung abscesses: review of 60 cases.

    PubMed

    Magalhães, Luísa; Valadares, Diana; Oliveira, Júlio R; Reis, Ernestina

    2009-01-01

    Lung abscesses (LA) carry with them severe clinical and social implications. The authors retrospectively analyse case files from a tertiary hospital. Admissions from 2000 to 2005 codified as LA were identified. Forty-five patients were males and the mean age was 56.2 (+/-15.1) years. The average duration of symptoms pre-hospitalisation was 23.0 (+/-50.2) days, with acute respiratory infection the initial syndrome in 36 patients. Clinical data show LA could have been suspected in 40 patients. Diagnosis was established 8.7 (+/-11.4) days after admission. A microbial pathogen was recovered in 26 cases. Primary LA was diagnosed in 27 patients. Dental disease and immunodeficiency were the main risk factors. Other co-morbidities were present in 34 patients. Af- ter LA diagnosis, intravenous (IV) antibiotic (AB) was prescribed for 16.5 (+/-10.9) days with mean total AB time 39.2 (+/-15.7) days. Ten options of AB were used and 23 patients had their initial IV AB changed to a second choice. Six patients needed surgery. Apyrexia was achieved after 6.4 (+/-6.4) days of treatment. 21 patients had complications and 7 died. The mean length of hospital admission was 27.5 (+/-16.3) days and 38 patients were called for a follow-up visit. These data are generally in accordance with the literature. The high male percentage agrees with the similarly high prevalence of alcoholism and lung neoplasms in males. Key facts to ameliorate in order to improve prognosis and length of hospital admission could be a swifter diagnosis and consensus on the AB treatment.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    1994-01-01

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

  8. Transphrenic fistulization of a subphrenic abscess to lung parenchyma.

    PubMed

    Romijn, Sander; Sturm, Maarten; van der Schelling, Georges

    2005-01-01

    A 53-year-old woman was admitted with respiratory distress. For several years, she had chronic alcoholic pancreatitis with ductal stones that were treated with a stent and with shockwave lithotripsy. Both treatments were unsuccessful, and the pancreatitis was complicated with an infected pseudocyst. The pancreatic head had to be resected, which was complicated with recurrent subphrenic abscesses. She then was admitted with respiratory distress and initially diagnosed with pneumonia of the right lower lobe. Further investigations showed supradiaphragmatic and subdiaphragmatic air-fluid levels. In both collections Streptococcus milleri was cultured, and subsequently the patient was diagnosed with a fistula connecting the subdiaphragmatic abscess with pulmonary tissue. This was treated with intravenous amoxicillin/clavulanate and drainage of the subdiaphragmatic collection. She did not develop a pulmonary empyema, because multiple adhesions, which were due to recurrent abscesses after pancreatic surgery, prevented breakthrough into the pleural cavity.

  9. [US-guided transhepatic drainage of a mediastinal abscess].

    PubMed

    Simón-Yarza, I; Viteri-Ramírez, G; García-Lallana, A; Benito, A

    2014-01-01

    Anastomoses often leak after esophageal surgery; if they are not detected in time, leaks can give rise to complications like fluid collections, superinfections, and mediastinitis. Although these complications usually require surgical treatment, different series of patients successfully treated with conservative or minimally invasive approaches have been reported. We present the case of a patient who developed a mediastinal abscess after epiphrenic diverticulectomy. We treated the abscess with US-guided percutaneous transhepatic drainage to avoid surgical reintervention. Although other cases of a transhepatic approach to thoracic lesions have been reported, to our knowledge this is the first report of this technique in mediastinal abscesses. We recommend that transhepatic drainage be considered a therapeutic option in the management of these complications. PMID:22464798

  10. Perinephric abscess caused by ruptured retrocecal appendix: MDCT demonstration

    PubMed Central

    Wani, Nisar Ahmad; Farooq, Mir; Gojwari, Tariq; Kosar, Tasleem

    2010-01-01

    Acute appendicitis may occasionally become extraordinarily complicated and life threatening yet difficult to diagnose. One such presentation is described in a 60-year-old man who was brought to the hospital due to right lumbar pain and fever for the last 15 days. Ultrasonography showed a right perinephric gas and fluid collection. Abdominal computed tomography with multidetector-row CT (MDCT) revealed gas-containing abscess in the right retroperitoneal region involving the perinephric space, extending from the lower pole of the right kidney up to the bare area of the liver. Inflamed retrocecal appendix was seen on thick multiplanar reformat images with its tip at the lower extent of the abscess. Laparotomy and retroperitoneal exploration were performed immediately and a large volume of foul smelling pus was drained. A ruptured retrocecal appendix was confirmed as the cause of the abscess. PMID:20842255

  11. Colonic diverticular abscess presenting as chronic diarrhea: a case report

    PubMed Central

    2009-01-01

    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. PMID:20076780

  12. Penetrating gastric ulcer presenting as a subcapsular liver abscess.

    PubMed

    Venkatesh, Kota R; Halpern, Andrew; Riley, Lee B

    2007-01-01

    This report describes a subcapsular liver abscess secondary to a penetrating gastric ulcer. The initial read on the CT scan misinterpreted the abscess cavity as an opacified loop of bowel, although it was very conspicuous on a retrospective review. A penetrating gastric ulcer was identified with esophagogastroduodenoscopy and the subcapsular liver abscess was subsequently detected using MRI. Although the conventional treatment of this condition is surgery, successful management was accomplished with a combination of percutaneous drainage, Helicobacter pylori eradication, and acid-suppressive therapy. A review of the literature is provided, including associated cases and the diagnostic modalities used in the evaluation of this condition. This case illustrates how one can arrive at the correct diagnosis with the use of multiple complementary modalities of investigation.

  13. Klebsiella pneumoniae liver abscess in an immunocompetent child.

    PubMed

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

    2013-09-01

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

  14. A Case Of Atypical Presentation of Thoracic Osteomyelitis & Paraspinal Abscess

    PubMed Central

    Acharya, Utkarsh

    2008-01-01

    Here presented is a case involving a 44-year-old man with a chief complaint of sharp lateral right-sided rib pain with notable radiation to the anterior portion of the thorax and minor radiation around the lateral back. The etiology of the pain and radiculopathy, which was initially attributed to a right-sided rib fracture, was later accurately credited to a paraspinal abscess discovered on a lateral X-ray of the thoracic spine. Subsequently, studies including Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and bone scan all confirmed the diagnosis of a paraspinal abscess between the right lobe and its neighboring T9 and T10 vertebrae. The mass was biopsied and methicillin sensitive Staphylococcus aureus was isolated. Appropriate surgical and medical intervention was possible due to the early diagnosis of the abscess. PMID:19148317

  15. [Occipital dermal sinus associated to a cerebellar abscess. Case].

    PubMed

    Costa, J M; de Reina, L; Guillén, A; Claramunt, E

    2004-10-01

    Congenital dermal sinuses are tubular tracts which communicate the skin with deeper structures. It is a manifestation of defective separation of the ectoderm and neuroderm. The incidence is 1/2500-3000 births alive. Almost 10 % of congenital dermal sinuses are localized in the occipitocervical region. They are usually asymptomatic, unless an infectious process is concurrent (meningitis, abscess). We are presenting the case of a 12 months girl with unnoticed cutaneous stigmata in the occipital region, who was admitted with a meningeal syndrome and secondary neurological impairment. She had a cerebellar abscess and was treated with decompression by puncture of the abscess and antibiotics. When infection was resolved, congenital dermal sinus was excised. Process solves without morbidity. We reviewed the clinical and therapeutic features in cases reported previously in the literature.

  16. Advanced Gastric Cancer Perforation Mimicking Abdominal Wall Abscess

    PubMed Central

    Cho, Jinbeom; Park, Ilyoung; Lee, Dosang; Sung, Kiyoung; Baek, Jongmin

    2015-01-01

    Surgeons occasionally encounter a patient with a gastric cancer invading an adjacent organ, such as the pancreas, liver, or transverse colon. Although there is no established guideline for treatment of invasive gastric cancer, combined resection with radical gastrectomy is conventionally performed for curative purposes. We recently treated a patient with a large gastric cancer invading the abdominal wall, which was initially diagnosed as a simple abdominal wall abscess. Computed tomography showed that an abscess had formed adjacent to the greater curvature of the stomach. During surgery, we made an incision on the abdominal wall to drain the abscess, and performed curative total gastrectomy with partial excision of the involved abdominal wall. The patient received intensive treatment and wound management postoperatively with no surgery-related adverse events. However, the patient could not receive adjuvant chemotherapy and expired on the 82nd postoperative day. PMID:26468420

  17. Simultaneous Esophageal and Tracheal Fistulization Resulting From Pott's Abscess.

    PubMed

    Eroglu, Atilla; Aydin, Yener; Ogul, Hayri; Altuntas, Bayram

    2016-10-01

    We describe a case of a 30-year-old woman who presented with a complaint of coughing while drinking water, which began 2 months earlier and was treated with surgical repair of esophageal and tracheal fistulization that resulted from a Pott's abscess. The patient had been diagnosed with pulmonary tuberculosis 4 years previously and had been treated for 6 months. Esophageal and tracheal fistulization of the abscess cavity was observed both radiologically and intraoperatively. The fistulas were closed through separate operations for the trachea and the esophagus. Simultaneous esophageal and tracheal fistulization of a Pott's abscess is a serious complication of spinal tuberculosis that has not been previously reported in the literature. PMID:27645978

  18. Conservative treatment of retropharyngeal and parapharyngeal abscess in children.

    PubMed

    Pelaz, Andrés Coca; Allende, Ana Vivanco; Llorente Pendás, Jose Luis; Nieto, Carlos Suárez

    2009-07-01

    Parapharyngeal and retropharyngeal infections, which can potentially cause life-threatening complications, could be treated conservatively with no need for surgical drainage. A retrospective analysis of all patients diagnosed with retropharyngeal and parapharyngeal infections was performed. Information regarding age, sex, presenting symptoms, physical examination, laboratory and imaging evaluations, management, duration of hospital stay, and complications were reviewed. Seven children were identified, 4 with retropharyngeal abscess and 3 with parapharyngeal abscess. All but 1 patient were under 7 years old, and all were treated with intravenous amoxicilin/clavulanic acid and corticosteroids. Torticollis and fever were present in all the patients. The mean length of hospital stay was 7 days. There were no complications associated. We demonstrate that retropharyngeal and parapharyngeal abscesses can be treated medically, reserving the surgical drainage for complicated cases. Treatment with intravenous antibiotics and corticosteroids is a safe option, reducing the durations of symptoms and the length of hospital stay.

  19. Prostatic abscess: diagnosis and management in the modern antibiotic era.

    PubMed

    Tiwari, Punit; Pal, Dilip K; Tripathi, Astha; Kumar, Suresh; Vijay, Mukesh; Goel, Amit; Sharma, Pramod; Dutta, Arindam; Kundu, Anup K

    2011-03-01

    This retrospective study was aimed at analyzing the clinical findings and therapeutic strategies in 24 patients who were admitted with prostatic abscess, during the period from 1999 to 2008. The diagnosis of prostatic abscesses was made clinically by digital rectal palpation based on the presence of positive fluctuation with tenderness. All cases were confirmed by trans-rectal ultrasound (TRUS), and only positive cases were included in this study. The diagnostic work-up included analysis of midstream urine and abscess fluid culture for pathogens. Therapeutic options included endoscopic trans-urethral incision or trans-perineal aspiration under ultrasound guidance, or conservative therapy. Of the 24 patients studied, 45.83% of the cases had a pre-disposing factor, and diabetes mellitus (37.50%) was the most common. Digital rectal palpation revealed fluctuation in 70.83% of the cases. Trans-abdominal ultrasonography missed the condition in 29.16% of the cases. On TRUS, all the study patients showed hypo-echoic zones, while nine others showed internal septations. In most of the cases, the lesion was peripheral. A causative pathogen could be identified in 70.83% of the cases. Surgical drainage of the abscess by trans-urethral deroofing was performed in 17 cases (including one with failed aspiration), trans-perineal aspiration under TRUS guidance was performed in three cases and conservative therapy was followed in five cases. Our data confirms the importance of predisposing factors in the pathogenesis of prostatic abscess. In most of the cases, the clue to diagnosis is obtained by digital rectal palpation. TRUS gives the definite diagnosis and also helps in follow-up of patients. Trans-urethral deroofing is the ideal therapy where the abscess cavity is more than 1 cm, although in some selected cases, TRUS-guided aspiration or conservative therapy does have a role in treatment. PMID:21422629

  20. Sterile Seroma after Drainage of Purulent Muscle Abscess in Crohn's Disease: Two Cases

    PubMed Central

    Treitman, Adam; Tabriz, Muhammed

    2016-01-01

    Purulent skeletal muscle abscesses can occur in Crohn's disease. We report a case of a sterile seroma complicating percutaneous drainage of a purulent skeletal muscle abscess in Crohn's ileitis. We compare and contrast this case with a similar case we published earlier. We emphasize the importance of recognition and differentiation from a septic purulent abscess. PMID:27529038

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

    PubMed

    Kozlowski, K

    1980-09-01

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

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

    PubMed

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

    2015-09-01

    Infective endocarditis is relatively uncommon in the pediatric population, but when it does occur, results in substantial morbidity and mortality. Children at risk for endocarditis are typically those with an underlying congenital heart condition. Furthermore, an endocardial abscess is a very rare yet serious complication of infective endocarditis. We describe a case of a 23-month-old previously healthy male infant with no known congenital heart disease who returned to the emergency department after a recent hospitalization for pneumococcal bacteremia, presenting acutely ill but without fever. He was found to be in congestive heart failure due to endocarditis and an aortic root abscess. PMID:26335231

  3. Visceral larva migrans presenting as multiple intracranial and intraspinal abscesses.

    PubMed

    Moiyadi, Alefia; Mahadevan, Anita; Anandh, Balasubramaniam; Shivashankar, Ravi Shankar; Chickabasavaiah, Yasha Thagadur; Shankar, Susarla Krishna

    2007-08-01

    Involvement of nervous system by toxocariasis is rare and can produce a spectrum of pathology that includes eosinophillic meningoencephalitis, meningomyelitis, space occupying lesions, vasculitis causing seizures or behavioral abnormalities posing diagnostic dilemmas. We describe a 38-year-old man who presented with multiple intracranial and intramedullary abscesses caused by visceral larva migrans. Neurohelminthiasis as a cause of multiple abscesses, though rare, should be entertained as a differential diagnosis particularly in tropical South-east Asian countries where helminthiasis is still an epidemiological concern prevalent in the pediatric age group. PMID:17899691

  4. [DIFFERENTIAL DIAGNOSIS OF TUMOROID-LIKE ABSCESS AND LUNG CANCER].

    PubMed

    Churylin, R

    2015-01-01

    The purpose of work is development and clarification of roentgenology displays of tumoroidea variant of abscess of lungs for differential diagnostics him with the cancer of lungs. Practically in most cases abscess of lungs there is a necessity of leadthrough of differential diagnostics with in a number of nosology forms, including with the cavernous form of peripheral cancer of lungs. The features of flow of roentgenologic picture of tumoroidea variant are resulted, alike symptoms, differ ences and signs which allow to set a correct diagnosis, are resulted, the value of follow-up of roent genologic research and use of computed tomography is underlined.

  5. Melioidosis of Chest Wall Masquerading as a Tubercular Cold Abscess

    PubMed Central

    Vishnu Prasad, Nelamangala Ramakrishnaiah; Balasubramaniam, Gopal; Karthikeyan, Vilvapathy Senguttuvan; Ramesh, Chakravarti Kapil; Srinivasan, Krishnamachari

    2012-01-01

    Melioidosis caused by Burkholderia pseudomallei, an important human pathogen in the tropical regions causes protean and multisystem clinical manifestations. A 50-year-old man on treatment for pulmonary tuberculosis developed a chest wall abscess. With a suspicion of tuberculous cold abscess, pus culture was done and it revealed Burkholderia pseudomallei. He was treated with 10 days of ceftazidime and incision and drainage was done. Wound healed well and he has now completed three months of oral cotrimoxazole eradication therapy and is on follow-up without recurrence. We report this case for the unusual presentation of melioidosis and the diagnostic challenge posed due to clinical similarity with tuberculosis. PMID:23741590

  6. Treatment of Acute Puerperal Mastitis and Breast Abscess

    PubMed Central

    Cantlie, Helene Bertrand

    1988-01-01

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

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

    PubMed

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

    2016-03-01

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

  8. Gallbladder Fossa Abscess Masquerading as Cholecystitis After Cholecystectomy.

    PubMed

    Rodrigue, Paul; Fakhri, Asif; Baumgartner, Andrew

    2015-12-01

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

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

    PubMed

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

    2015-09-01

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

  10. Multiple Medium Amoebic Liver Abscesses Successfully Treated with Medication and Comprehensive Percutaneous Catheter Drainage.

    PubMed

    Kasamatsu, Yu; Shirano, Michinori; Iida, Ko; Shimizu, Sadatoshi; Goto, Tetsushi

    2016-01-01

    Solitary small (<5 cm) amoebic liver abscesses in the right lobe are generally treated using medication alone, while large abscesses are typically treated via a combination of medication and drainage. However, the therapeutic indications for multiple medium (5-10 cm) amoebic liver abscesses remain unclear. We herein report the findings of a 53-year-old woman who was receiving lenalidomide for multiple myeloma and subsequently developed multiple amoebic abscesses. Metronidazole alone was unsuccessful, although metronidazole and repeated percutaneous catheter drainage of the right lobe, left lobe, and thorax proved to ultimately be successful. Therefore, the successful use of medication alone may be associated with the total combined abscess volume. PMID:27523014

  11. Ewing's sarcoma in mandibular similar to dental abscess.

    PubMed

    Keshani, Forouz; Jahanshahi, Gholamreza; Attar, Bijan Movahedian; Kalantari, Mahsa; Razavi, Seyed Mohammad; Hashemzade, Zahra; Tavakoli, Payam

    2014-01-01

    Ewing's sarcoma is a rare malignant neoplasm that comprises approximately 4-6% of primary bone tumors. In most cases, femur and pelvis are affected, and less commonly the head and neck areas (in the jaws, usually the mandible). These tumors have been reported more frequently in males, mostly aged 5-20 years old. Systemic symptoms and signs such as fever, weight loss, anemia, leukocytosis, and elevated erythrocyte sedimentation rate (ESR) may be the first signs in oral Ewing's sarcoma. Such signs and symptoms are also seen in odontogenic infections and abscess. In one case, the patient went to a dentist with pain, swelling, and abscess similar to odontogenic infection and patient's tooth was pulled due to misdiagnosis. This tumor has an aggressive clinical behavior and is identified with rapid growth and high probability of metastasis at diagnosis. Thus, it is necessary to differentiate it from a dental abscess. As for the treatment of Ewing's sarcoma, first the tumor must undergo chemotherapy to reduce its size and, eventually, it undergoes extensive surgery. This case report deals with a 16-year-old patient wrongly diagnosed with odontogenic infection and abscess, and hospitalized. As the symptoms did not remit, biopsy was carried out and the patient was operated on with Ewing's sarcoma diagnosis. PMID:24627870

  12. 9 CFR 311.14 - Abrasions, bruises, abscesses, pus, etc.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Abrasions, bruises, abscesses, pus, etc. 311.14 Section 311.14 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT... excised, leaving only sound, normal tissue, which may be passed for human food. Any organ or other part...

  13. Bilateral lung abscess associated with a severe masticator space infection.

    PubMed

    Zaputowycz, O; Williams, F A; Arthur, A

    1986-04-01

    The clinician should be constantly aware of the danger of aspiration in cases of prolonged sepsis with profuse suppuration. In such cases, it might be wiser to establish dependent extraoral drainage, rather than relying solely on intraoral means. The chances of aspirating septic material and the resultant occurrence of pulmonary abscesses will be lessened.

  14. Pyogenic Liver Abscess Caused by Acinetobacter lwoffii: A Case Report

    PubMed Central

    Singh, N. Pal; Nirmal, Kirti; Kaur, I. Rajender

    2016-01-01

    Acinetobacter lwoffii is a gram negative aerobic non-fermenter bacilli. It is considered as an important emerging pathogen after Acinetobacter baumannii in patients with impaired immune system and in nosocomial infections. Here, we present a case of community acquired pyogenic liver Abscess caused by Acinetobacter lwoffii in a diabetic patient. PMID:27504286

  15. Abscess caused by vancomycin-resistant Lactobacillus confusus.

    PubMed Central

    Bantar, C E; Relloso, S; Castell, F R; Smayevsky, J; Bianchini, H M

    1991-01-01

    Several isolates of vancomycin-resistant Lactobacillus confusus from human sources have been described, but to our knowledge, no well-documented infection attributable to this organism has been published. A thumb abscess caused by this bacterium in a healthy 49-year-old male is reported here. He was successfully treated by surgical drainage and cephalothin. PMID:1774335

  16. Abscess caused by vancomycin-resistant Lactobacillus confusus.

    PubMed

    Bantar, C E; Relloso, S; Castell, F R; Smayevsky, J; Bianchini, H M

    1991-09-01

    Several isolates of vancomycin-resistant Lactobacillus confusus from human sources have been described, but to our knowledge, no well-documented infection attributable to this organism has been published. A thumb abscess caused by this bacterium in a healthy 49-year-old male is reported here. He was successfully treated by surgical drainage and cephalothin.

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

    PubMed Central

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

    2016-01-01

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

  18. Mycobacterium chelonae abscesses associated with biomesotherapy, Australia, 2008.

    PubMed

    Ivan, Mihaela; Dancer, Craig; Koehler, Ann P; Hobby, Michaela; Lease, Chris

    2013-01-01

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

  19. Otogenic cerebral abscess: an unusual complication of otitis media.

    PubMed

    Chang, Alice E; O, Teresa M

    2011-11-01

    Intracranial complications of otitis media are rare in the age of antiobiotics and in the developed world, but they can be life threatening when they occur. We present a case of a 47-year-old woman with no contributory otologic history who developed an otogenic temporal lobe abscess.

  20. Cerebral abscess complicating dilatation of a corrosive esophageal stricture.

    PubMed

    Djupesland, P; Solgaard, T; Mair, I W

    1991-01-01

    A case is presented in which a metastatic cerebral abscess developed in a 62-year-old female who required repeated dilatation for an esophageal stricture following accidental ingestion of liquid caustic soda. The literature is reviewed and management suggested for the avoidance of this uncommon complication.

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

    PubMed Central

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

    2015-01-01

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

  2. Pyogenic Liver Abscess Caused by Acinetobacter lwoffii: A Case Report.

    PubMed

    Singh, N Pal; Sagar, Tanu; Nirmal, Kirti; Kaur, I Rajender

    2016-06-01

    Acinetobacter lwoffii is a gram negative aerobic non-fermenter bacilli. It is considered as an important emerging pathogen after Acinetobacter baumannii in patients with impaired immune system and in nosocomial infections. Here, we present a case of community acquired pyogenic liver Abscess caused by Acinetobacter lwoffii in a diabetic patient. PMID:27504286

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

    PubMed

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

    2015-08-01

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

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

    PubMed Central

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

    2012-01-01

    Capnocytophaga species are known commensals of the oral cavity of humans and animals (mainly dogs and cats) and are a rare cause of respiratory tract infections. We report a case of cavitary lung abscess caused by a Capnocytophaga species in a patient with a metastatic neuroendocrine tumor. PMID:22075586

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

    PubMed Central

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

    2016-01-01

    AIM: To evaluate the clinical characteristics and progression of liver abscess caused by toxocara. METHODS: We retrospectively reviewed the medical records of patients with serum IgG antibody to Toxocara canis and liver abscess diagnosed using abdominal computed tomography between February 2010 and February 2015. Among 84 patients exhibiting serum IgG antibody to Toxocara canis, 34 patients were diagnosed with liver asbscess and treated with albendazole. A follow-up period of 1 year was conducted. RESULTS: Mean patient age was 53 (34-79) years, with 26 (76.5%) patients being male. Twenty-one (61.7%) patients were moderate or heavy drinkers, 23 (67.6%) patients had a history of eating raw meat or liver and 6 (17.6%) patients owned pet dogs or cats. Main patient symptoms consisted of right upper quadrant pain, fever, and fatigue; 18 (52.9%) patients, however, presented with no symptoms. Lung involvement was detected in 444 (11.7%) patients. The eosinophil count increased in 29 (85.3%) patients at initial diagnosis, and decreased in most patients after albendazole treatment. The initial serum IgE level increased in 25 (73.5%) patients, but exhibited various response levels after albendazole treatment. Liver abscess formation improved in all patients. CONCLUSION: The liver abscess was improved with albendazole treatment. PMID:27366302

  6. Legionella pneumophila lung abscess associated with immune suppression.

    PubMed

    Guy, S D; Worth, L J; Thursky, K A; Francis, P A; Slavin, M A

    2011-10-01

    Legionella species are a common cause of community-acquired pneumonia, infrequently complicated by cavitary disease. We describe Legionella pneumophila pneumonia and abscess formation in an immunosuppressed patient receiving corticosteroid therapy for metastatic breast carcinoma. The predisposing role of corticosteroids is discussed and the management of this complication is reviewed. PMID:22435900

  7. Capnocytophaga lung abscess in a patient with metastatic neuroendocrine tumor.

    PubMed

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

    2012-01-01

    Capnocytophaga species are known commensals of the oral cavity of humans and animals (mainly dogs and cats) and are a rare cause of respiratory tract infections. We report a case of cavitary lung abscess caused by a Capnocytophaga species in a patient with a metastatic neuroendocrine tumor. PMID:22075586

  8. [Clinico-roentgenological characteristics of acute lung abscess].

    PubMed

    Gadzhiev, S A; Anan'ina, G V; Abramov, Sh I

    1976-01-01

    Based on an analysis of the clinico-roentgenological picture of the disease in 48 patients with acute lung suppuration, the authors have detected some peculiarities in clinical manifestations of the disease, and also characteristic features of the roentgenological semiotics, which enabled them to define the pathological process as "a primary" acute abscess of the lung.

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

    PubMed

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

    2013-01-01

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

  10. Splenectomy and risk of renal and perinephric abscesses

    PubMed Central

    Lai, Shih-Wei; Lin, Hsien-Feng; Lin, Cheng-Li; Liao, Kuan-Fu

    2016-01-01

    Abstract Little epidemiological research is available on the relationship between splenectomy and renal and perinephric abscesses. The purpose of the study was to examine this issue in Taiwan. We conducted a population-based retrospective cohort study using the hospitalization dataset of the Taiwan National Health Insurance Program. A total of 16,426 participants aged 20 and older who were newly diagnosed with splenectomy from 1998 to 2010 were assigned to the splenectomy group, whereas 65,653 sex-matched, age-matched, and comorbidity-matched, randomly selected participants without splenectomy were assigned to the nonsplenectomy group. The incidence of renal and perinephric abscesses at the end of 2011 was measured in both groups. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for risk of renal and perinephric abscesses associated with splenectomy and other comorbidities including cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis. The overall incidence rate of renal and perinephric abscesses was 2.14-fold greater in the splenectomy group than that in the nonsplenectomy group (2.24 per 10,000 person-years vs 1.05 per 10,000 person-years, 95% CI 2.02, 2.28). After controlling for sex, age, cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis, the multivariable regression analysis demonstrated that the adjusted HR of renal and perinephric abscesses was 2.24 for the splenectomy group (95 % CI 1.30, 3.88), when compared with the nonsplenectomy group. In further analysis, the adjusted HR markedly increased to 7.69 for those comorbid with splenectomy and diabetes mellitus (95% CI 3.31, 17.9). Splenectomy is associated with renal and perinephric abscesses, particularly comorbid with diabetes mellitus. In view of its potential morbidity and mortality, clinicians should consider the possibility of renal and perinephric

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

    PubMed Central

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

    1987-01-01

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

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

    PubMed

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

    2015-01-01

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

  13. Distal cord-predominant longitudinally extensive myelitis with diffuse spinal meningitis and dural abscesses due to occult tuberculosis: A rare occurrence

    PubMed Central

    Kasundra, Gaurav M.; Sood, Isha; Bhushan, Bharat; Bhargava, Amita Narendra; Shubhkaran, Khichar

    2016-01-01

    Tuberculous myelitis usually involves thoracic and only rarely, distal cord. Longitudinal lesions more than three spinal segments long in tuberculosis (TB) are usually due to intramedullary tuberculomas and not infectious myelitis. We report a 17-year-old male with acute myelitis from D7 to conus medullaris, diffuse spinal meningitis, subdural and epidural abscesses, normal vertebrae, intervertebral discs, and brain imaging. Cerebrospinal fluid (CSF) showed raised proteins, lymphocytosis, hypoglycorrhagia, and positive TB-polymerase chain reaction. Chest X-ray was normal, and sputum was negative for acid-fast Bacilli. Chest computed tomography (CT) revealed endobronchial TB. The patient was successfully treated with antitubercular drugs and steroids. In endemic areas, a high index of suspicion should be kept for TB in patients with myelitis, especially those with spinal abscesses and a suggestive CSF report. In selected cases, there may be a role of CT scan inspite of normal X-ray. PMID:27195042

  14. Fatal persistent methicillin-resistant Staphylococcus aureus bacteremia and vascular graft infections complicated with the formation of multiple abscesses despite aggressive medical therapy

    PubMed Central

    Shiba, Mikio; Maeda, Hideaki; Shiono, Motomi

    2015-01-01

    A 40-year-old man underwent ascending aorta replacement for an acute type A aortic dissection. After the operations, methicillin-resistant Staphylococcus aureus was identified in sputum and blood cultures. Although anti-methicillin-resistant Staphylococcus aureus drugs were administered, most of the intermittent blood cultures remained positive. The focus of methicillin-resistant Staphylococcus aureus infection was not evident in the early stages, and no specific symptoms such as abscess or endocarditis were observed. However, abscesses in the brain, mediastinum and spleen were found 3 years after the operation. The minimum inhibitory concentration of vancomycin gradually increased from 1 to 4 µg/mL during the course of treatment. This case provides evidence for a potential role of combination therapy. PMID:27489691

  15. Aquaporin-4 and brain edema.

    PubMed

    Papadopoulos, Marios C; Verkman, Alan S

    2007-06-01

    Aquaporin-4 (AQP4) is a water-channel protein expressed strongly in the brain, predominantly in astrocyte foot processes at the borders between the brain parenchyma and major fluid compartments, including cerebrospinal fluid (CSF) and blood. This distribution suggests that AQP4 controls water fluxes into and out of the brain parenchyma. Experiments using AQP4-null mice provide strong evidence for AQP4 involvement in cerebral water balance. AQP4-null mice are protected from cellular (cytotoxic) brain edema produced by water intoxication, brain ischemia, or meningitis. However, AQP4 deletion aggravates vasogenic (fluid leak) brain edema produced by tumor, cortical freeze, intraparenchymal fluid infusion, or brain abscess. In cytotoxic edema, AQP4 deletion slows the rate of water entry into brain, whereas in vasogenic edema, AQP4 deletion reduces the rate of water outflow from brain parenchyma. AQP4 deletion also worsens obstructive hydrocephalus. Recently, AQP4 was also found to play a major role in processes unrelated to brain edema, including astrocyte migration and neuronal excitability. These findings suggest that modulation of AQP4 expression or function may be beneficial in several cerebral disorders, including hyponatremic brain edema, hydrocephalus, stroke, tumor, infection, epilepsy, and traumatic brain injury.

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

    PubMed Central

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

    2015-01-01

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

  17. Radiofrequency ablation of a misdiagnosed Brodie’s abscess

    PubMed Central

    Chan, RS; Abdullah, BJJ; Aik, S; Tok, CH

    2011-01-01

    Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie’s abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie’s abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment. PMID:22291860

  18. Spinal epidural abscess: the importance of early diagnosis and treatment

    PubMed Central

    Mackenzie, A; Laing, R; Smith, C; Kaar, G; Smith, F

    1998-01-01

    OBJECTIVES—To remind clinicians of the dangers of delayed diagnosis and the importance of early treatment of spinal epidural abscess.
METHODS—A review of the literature on spinal epidural abscess and a comparison of the published literature with local experience.
RESULTS—Imaging with MRI or CT enables early diagnosis of spinal epidural abcess and optimal therapy is surgical evacuation combined with 6-12 weeks (median 8 weeks) of antimicrobial chemotherapy. Clinical features are fever, pain, and focal neurological signs and may be associated with preceding and pre-existing bone or joint disease. The commonest aetiological organism is S aureus.
CONCLUSION—Early diagnosis and appropriate early antimicrobial chemotherapy with surgery is associated with an excellent prognosis.

 PMID:9703173

  19. Transient Broca's aphasia as feature of an extradural abscess.

    PubMed

    Commondoor, Raghuram; Eisenhut, Michael; Fowler, Charlotte; Kirollos, Ramirez W; Nathwani, Nisha

    2009-01-01

    Diagnosis of extradural abscesses can be difficult and is often delayed. The case is presented of a 13-year-old girl who was afebrile and had episodes of expressive aphasia, with maintenance of awareness and understanding, lasting for 2-3 minutes and with normal neurologic examination in between. She was found to have a left frontal extradural abscess overlying the region of Broca's area (Brodmann area 44/45) on magnetic resonance imaging. An electroencephalogram showed continuous delta activity in the left frontotemporal region. She made a full recovery after surgical evacuation of pus, which upon culture grew Streptococcus milleri. The possible cause of transient aphasia in this condition is pressure-induced or inflammatory mediator-induced ischemia, with or without associated focal seizures. PMID:19068255

  20. Paralaryngeal Abscess with Laryngeal Hemiplegia and Fistulation in a Horse

    PubMed Central

    Barber, S. M.

    1981-01-01

    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. PMID:7337917

  1. Paralaryngeal abscess with laryngeal hemiplegia and fistulation in a horse.

    PubMed

    Barber, S M

    1981-12-01

    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.

  2. Anaerobic orbital abscess/cellulitis in a Yorkshire Terrier dog.

    PubMed

    Homma, K; Schoster, J V

    2000-10-01

    A retrobulbar abscess/cellulitis occurred in a Yorkshire Terrier dog. The clinical signs were exophthalmos, prolapsed nictitating membrane and purulent ocular discharge. Ultrasonography showed a marked soft tissue swelling of the retrobulbar tissues as well as echogenic parallel lines between the globe and the medial orbital rim. Surgical exploration of the orbit was performed and no foreign body was found. The pterygopalatine fossa was incised and therapeutic retrobulbar drainage attempted. A drain was placed to encourage ventral drainage of the abscess. Anaerobic cultures revealed heavy growth of gram negative rods (prevotella bivia and prevotella buccae were isolated). Recovery was successful but subsequent treatment for keratoconjunctivitis sicca was necessary. A full recovery of tear production occurred after several weeks.

  3. Tubo-ovarian abscess with Morganella morganii bacteremia.

    PubMed

    Chou, Yen Yi; Chiu, Sheng Kang; Lai, Hung Cheng; Chang, Feng Yee

    2009-08-01

    Tubo-ovarian abscess caused by Morganella morganii is unusual. A 54-year-old menopausal woman visited the emergency room with lower abdominal pain, vomiting, and fever for 4 days. Pelvic examination revealed lifting tenderness over the right adnexum without motion tenderness of the uterus. Pelvic sonogram revealed a cystic lesion with heterogeneous content in the right ovary. Salpingo-oophoritis was suspected. Clindamycin and gentamicin were administered intravenously after obtaining blood cultures. Laparoscopy was done because of sustained fever, and an ovarian abscess was found. Laparoscopic salpingo-oophorectomy was performed. The patient was discharged 5 days later and oral clindamycin was prescribed. However, she was readmitted due to intermittent fever. The result of blood culture obtained before surgery disclosed M. morganii, which was resistant to clindamycin and cefazolin. Her symptoms resolved after administration of intravenous flomoxef. This report highlights the fact that antimicrobial resistance of M. morganii may complicate the management and outcome of this infection.

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

    PubMed

    Silva, Ana M; Schmalbach, Lauwence A

    2016-10-01

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

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

    PubMed

    Silva, Ana M; Schmalbach, Lauwence A

    2016-10-01

    Psoas abscess is a common disease in children. It can have a nonspecific clinical presentation, insidious onset and sometimes fever. The most common type in children is the primary one; however, it can sometimes be of secondary origin and associated with severe infections such as osteomyelitis so a high index of suspicion is required to detect and treat it promptly. We present an unusual case of psoas abscess with infiltration of the vertebral body of L2 in a 14 year old male patient previously healthy with no history of trauma or fever on admission. X-ray and ultrasound were performed but the diagnosis was confirmed by magnetic resonance imaging of the lumbosacral spine. With positive blood cultures for methicillin-resistant Staphylococcus aureus he completed 2 weeks of intravenous antibiotic therapy and 4 weeks of oral antibiotic therapy with blood cultures negativization and resolution of symptoms. PMID:27606657

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2015-01-01

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

  9. An unusual case of non-traumatic pneumococcal mediastinal abscess.

    PubMed

    Lotan, C; Boneh, A; Tamir, I; Goitein, K J

    1985-01-01

    A 16-month old baby developed severe respiratory failure because of acute laryngitis and required mechanical ventilation. Intubation was complicated by aspiration and development of chemical pneumonia. Following 4 days of treatment the child was successfully extubated. Thirty six hours after extubation the patient again developed respiratory failure and on chest X-ray pneumomediastinum was seen and later evidence of a mediastinal abscess. Conservative treatment, with antibiotics, effected complete cure.

  10. Meckel’s diverticulum manifested by a subcutaneous abscess

    PubMed Central

    Karatepe, Oguzhan; Adas, Gokhan; Altıok, Merih; Ozcan, Deniz; Kamali, Sedat; Karahan, Servet

    2009-01-01

    This case report describes an extremely rare complication of a Meckel’s diverticulum: enterocutaneous fistula of the diverticulum. The presence of Meckel’s diverticulum is a well known entity, but subcutaneous perforation of the diverticulum is very rare. Here we report the case of a patient with the complaint of a right lower quadrant abscess, preoperatively diagnosed as enterocutaneous fistula, which was determined intraoperatively to be a fistula resulting from Meckel’s diverticulum. PMID:20027688

  11. Migratory and misleading abscess of oro-facial region

    PubMed Central

    ArunKumar, Kubsad Veerabhadrappa; Deepa, Dhruvakumar

    2015-01-01

    Acute pericoronitis usually presents with severe localized pain, swelling and sometimes trismus. However, chronic pericoronitis and periodontal abscess produce a dull pain, moderate swelling and are occasionally seen migrating into distant sites producing fistulae intra-orally and/or extra-orally. This may quite often cause diagnostic dilemmas necessitating thorough medical and dental history, careful clinical examination and sometimes special investigations to confirm the etiology and or origin of infection. Here, we present three such cases and their management. PMID:26392702

  12. Left main compression by an aortic root abscess.

    PubMed

    Misuraca, Leonardo; De Caro, Francesco; De Carlo, Marco; Barzaghi, Carlo; Scioti, Gianni; Minzioni, Gaetano; Petronio, Anna S

    2012-03-01

    A 79-year-old man with severe aortic stenosis, history of coronary artery disease and a recent hospitalization for sepsis presented at our institution following a syncope and angina at rest. Coronary angiography and aortography showed an aortic root abscess, causing left main coronary artery compression. This life-threatening complication of aortic valve endocarditis is rare and requires immediate surgical correction. PMID:22306781

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

    PubMed

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

    2016-01-01

    Raoultella species are a group of gram-negative, non-motile bacilli commonly isolated from the environment. The group was considered a member of the genus Klebsiella until the late 1990s. Raoultella planticola is a rare cause of human infections. We report the first case of liver abscess caused by this organism. The patient was successfully treated with appropriate antimicrobials combined with operative drainage. PMID:27516968

  14. Brodie's abscess in a tibia dating from the Neolithic period.

    PubMed

    Lagier, R; Baud, C A; Kramar, C

    1983-01-01

    Radiological and macroscopic characteristics typical of Brodie's abscess were observed in inferior metaphysis of a tibia estimated to be 5,000 years old. The use of rigorous anatomico-radiological criteria in studies of bone paleopathology can provide the doctor with accurate data regarding diseases of the past in bone specimens rarely at their disposal. This approach is also necessary to obtain valid data for paleontologists, prehistorians and archeologists.

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

    PubMed

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

    2014-08-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    1989-05-01

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

  18. Indium-111 leukocyte scanning. False-negative study in a renal abscess

    SciTech Connect

    Kumar, R.; Bedi, D.G.; Fawcett, H.D.; Winsett, M.Z.; Fagan, C.J.

    1986-04-01

    A 33-year-old man had clinical features of a right renal abscess. Results of excretory urography and ultrasonography showed a focal complex mass lesion in the right kidney. An In-111 leukocyte scan failed to detect the right renal abscess, which later was aspirated under CT guidance and explored surgically. The role of In-111 leukocyte imaging in the detection of intra-abdominal abscesses, with limitations of the procedure, is discussed.

  19. Tuberculous cold abscess of breast: an unusual presentation in a male patient

    PubMed Central

    Brown, Sarah

    2016-01-01

    Tuberculosis (TB) of breast is a rare condition especially presentation as a cold abscess. We present a case of male patient with TB of lung and meninges with a cold abscess in the breast. The abscess was incidental finding on the computed tomography (CT) scan. This was further managed by a combination of anti-tuberculous chemotherapy treatment and surgical drainage. We reviewed the current literature related to mammary TB, its presentations and treatment. PMID:27294045

  20. Salmonella typhi Splenic Abscess Following Blunt Abdominal Injury: A Case Report

    PubMed Central

    Sharavanan, Priyadarshini; Palraj, Kennedy Kumar; Antony, Tessa; Thayanidhi, Premamalini

    2016-01-01

    Splenic abscess as a complication of enteric fever due to Salmonella typhi is a rare entity. Here, we are presenting a case of splenic abscess caused by Salmonella typhi with a blunt injury to the abdomen as the predisposing factor. The patient underwent total splenectomy due to failure of conservative management. Splenic abscess is a potential life threatening disease if left untreated. In spite of its rarity, Salmonella typhi has to be considered as a possible pathogen causing the disease. PMID:27630844

  1. Salmonella typhi Splenic Abscess Following Blunt Abdominal Injury: A Case Report.

    PubMed

    Sharavanan, Priyadarshini; Shanmugam, Dhivyalakshmi; Palraj, Kennedy Kumar; Antony, Tessa; Thayanidhi, Premamalini

    2016-07-01

    Splenic abscess as a complication of enteric fever due to Salmonella typhi is a rare entity. Here, we are presenting a case of splenic abscess caused by Salmonella typhi with a blunt injury to the abdomen as the predisposing factor. The patient underwent total splenectomy due to failure of conservative management. Splenic abscess is a potential life threatening disease if left untreated. In spite of its rarity, Salmonella typhi has to be considered as a possible pathogen causing the disease. PMID:27630844

  2. Sciatica: An Extremely Rare Complication of the Perianal Abscess

    PubMed Central

    Gujrathi, Rahul; Gupta, Kanchan; Ravi, Chetan; Pai, Bhujang

    2016-01-01

    Summary Background Sciatica has been classically described as pain in the back and hip with radiation in the leg along the distribution of the sciatic nerve, secondary to compression or irritation of the sciatic nerve. Spinal abnormality being the most common etiology, is one of the most common indications for MRI of the lumbosacral spine. Here we describe imaging findings secondary to a supralevator perianal abscess causing irritation of the sciatic nerve, which was diagnosed on MRI of the lumbosacral spine. Case Report A 47-year-old male patient presented to the emergency department with severe acute pain in the right hip and right leg which was aggravated by limb movement. Clinically, a possibility of sciatica was suggested and MRI of the lumbosacral spine was ordered. The MRI did not reveal any abnormality in the lumbosacral spine; however, on STIR coronal images, a right perianal abscess with air pockets was seen. The perianal abscess was extending above the levator ani muscle with and was seen tracking along the sciatic nerve, explaining pain along the distribution of the sciatic nerve. The abscess was surgically drained, followed by an antibiotic course. The patient was symptomatically better post-surgery. Post-operative scan done 3 days later revealed significant resolution of the infra- and supralevator perianal abscess. The patient was discharged from hospital on post-operative day 3 on oral antibiotics for 7 days. On 15th post-operative day, the patient was clinically completely asymptomatic with good healing of the perianal surgical wound. Conclusions Extra-spinal causes are rare and most often overlooked in patients with sciatica. While assessing patients with sciatica, extra-spinal causes for the radiation of pain along the distribution of the sciatic nerve should always be looked for if abnormalities in the MRI of the lumbar spine are not found. Inclusion of STIR sequences in the imaging of the lumbosacral spine, more often than not, helps to

  3. Surgical Treatment of Facial Abscesses and Facial Surgery in Pet Rabbits.

    PubMed

    Capello, Vittorio

    2016-09-01

    Odontogenic facial abscesses associated with periapical infections and osteomyelitis of the jaw represent an important part of the acquired and progressive dental disease syndrome in pet rabbits. Complications such as retromasseteric and retrobulbar abscesses, extensive osteomyelitis of the mandible, and empyemas of the skull are possible sequelae. Standard and advanced diagnostic imaging should be pursued to make a detailed and proper diagnosis, and plan the most effective surgical treatment. This article reviews the surgical anatomy, the pathophysiology, and the classification of abscesses and empyemas of the mandible, the maxilla, and the skull. It also discusses surgical techniques for facial abscesses.

  4. Clinical, Laboratory, and Management Profile in Patients of Liver Abscess from Northern India

    PubMed Central

    Ghosh, Soumik; Sharma, Sourabh; Gadpayle, A. K.; Gupta, H. K.; Mahajan, R. K.; Sahoo, R.; Kumar, Naveen

    2014-01-01

    Objective. To describe the clinical profile, microbiological aetiologies, and management outcomes in patients with liver abscess. Methods. A cross-sectional study was conducted from May, 2011, to April, 2013, on 200 consecutive liver abscess patients at PGIMER and Dr. RML Hospital, New Delhi. History, examination, and laboratory investigations were recorded. Ultrasound guided aspiration was done and samples were investigated. Chi-square test and multivariate regression analysis were performed to test association. Results. The mean age of patients was 41.13 years. Majority of them were from lower socioeconomic class (67.5%) and alcoholic (72%). The abscesses were predominantly in right lobe (71%) and solitary (65%). Etiology of abscess was 69% amoebic, 18% pyogenic, 7.5% tubercular, 4% mixed, and 1.5% fungal. Percutaneous needle aspiration was done in 79%, pigtail drainage in 17%, and surgical intervention for rupture in 4% patients. Mortality was 2.5%, all reported in surgical group. Solitary abscesses were amoebic and tubercular whereas multiple abscesses were pyogenic (P = 0.001). Right lobe was predominantly involved in amoebic and pyogenic abscesses while in tubercular abscesses left lobe involvement was predominant (P = 0.001). Conclusions. The commonest presentation was young male, alcoholic of low socioeconomic class having right lobe solitary amoebic liver abscess. Appropriate use of minimally invasive drainage techniques reduces mortality. PMID:25002869

  5. Corpus cavernosum abscess from a blind-ending urethra after urinary diversion surgery

    PubMed Central

    Kumabe, Ayako; Kenzaka, Tsuneaki; Yamamoto, Yu; Kajii, Eiji

    2013-01-01

    Corpus cavernosum abscesses are rarely seen in the clinical setting. We report the case of an early diagnosis of corpus cavernosum abscess due to a blind-ending urethra in a 60-year-old man without known risk factors and who was successfully treated by antibiotic therapy alone. In this case, the blind-ending urethra after urinary diversion surgery was considered a risk factor of the abscess formation. If the physician notes that the patient has fever of uncertain cause after urinary diversion surgery, he/she should examine the penis and perineum in consideration of the possibility of corpus cavernosum abscess. PMID:23616331

  6. Liver Abscess With a Markedly High Level of Carbohydrate Antigen 19-9

    PubMed Central

    Yoshino, Yusuke; Seo, Kazunori; Koga, Ichiro; Matsunaga, Naohisa; Kitazawa, Takatoshi; Takamori, Yoriyuki; Ota, Yasuo

    2012-01-01

    Serological tumor markers are useful for detection of malignancies and evaluation of disease progression. However, some markers are rarely elevated in patients with benign diseases and without malignancies. We herein present a case of a liver abscess with a highly elevated carbohydrate antigen (CA 19-9) level in both the serum and abscess fluid. The serological level of CA 19-9 decreased with treatment. Although CA 19-9 is known to be a specific tumor marker, high serum levels of CA 19-9 can be observed in patients with pyogenic liver abscesses. CA 19-9 may also be a marker for treatment response in patients with liver abscesses.

  7. Cervical epidural abscess: rare complication of bacterial endocarditis with streptococcus viridans: a case report.

    PubMed

    Oh, Jae-Sang; Shim, Jai-Joon; Lee, Kyeong-Seok; Doh, Jae-Won

    2015-03-01

    Although many patients with infective endocarditis (IE) complain of joint, muscle, and back pain, infections at these sights are rare. The incidence of spinal abscess in cervical spine complicating endocarditis is very rare. Although the surgical management is the mainstay of treatment, conservative treatment can get success in selected patients. We report a patient with cervical epidural abscess due to Streptococcus viridans endocarditis. Both epidural abscess and IE were managed conservatively with intravenous antibiotics for 8 weeks, with recovery. It is important to remind spinal epidural abscess can occur in those patients with bacterial endocarditis. PMID:25883665

  8. Recurrent abscesses due to Finegoldia magna, Dermabacter hominis and Staphylococcus aureus in an immunocompetent patient.

    PubMed

    Martin, J; Bemer, P; Touchais, S; Asseray, N; Corvec, S

    2009-10-01

    A case of recurrent abscesses in an immunocompetent patient is reported, involving the opportunistic human pathogen Dermabacter hominis, the virulent anaerobic pathogen Finegoldia magna and Staphylococcus aureus.

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

    PubMed

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

    2014-01-01

    A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management. PMID:24898408

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

    PubMed

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

    2003-10-01

    Epidemiologic determinants of 46 cases of aural abscessation in free-living eastern box turtles (Terrapene carolina) admitted to the Wildlife Center of Virginia (Virginia, USA) from 1991 to 2000 were evaluated. County human population density, year and season of admission, weight, and sex did not affect the risk for box turtles to develop aural abscessation. Counties with cases of aural abscessation were not randomly distributed, but rather were clustered into two multi-county regions. Geographic location was the only risk factor associated with aural abscessation in box turtles found in this study. Possible etiologies could include chronic infectious disease, malnutrition, or chronic exposure to environmental contamination with organochlorine compounds.

  11. Penile abscess secondary to neglected penile fracture after intracavernosal vasoactive drug injection.

    PubMed

    Song, Wan; Ko, Kwang Jin; Shin, Seung Jea; Ryu, Dong Soo

    2012-12-01

    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. PMID:23596611

  12. Surgical Treatment of Facial Abscesses and Facial Surgery in Pet Rabbits.

    PubMed

    Capello, Vittorio

    2016-09-01

    Odontogenic facial abscesses associated with periapical infections and osteomyelitis of the jaw represent an important part of the acquired and progressive dental disease syndrome in pet rabbits. Complications such as retromasseteric and retrobulbar abscesses, extensive osteomyelitis of the mandible, and empyemas of the skull are possible sequelae. Standard and advanced diagnostic imaging should be pursued to make a detailed and proper diagnosis, and plan the most effective surgical treatment. This article reviews the surgical anatomy, the pathophysiology, and the classification of abscesses and empyemas of the mandible, the maxilla, and the skull. It also discusses surgical techniques for facial abscesses. PMID:27497207

  13. Indium-111 labeled leukocytes in the evaluation of suspected abdominal abscesses.

    PubMed

    Coleman, R E; Black, R E; Welch, D M; Maxwell, J G

    1980-01-01

    Sixty-eight indium-111-labeled leukocyte imaging studies were performed in 53 patients with suspected abdominal abscesses. Twenty-nine studies gave abnoramal results. Nine wound infections were demonstrated, and 14 abscesses were correctly identified. Four studied demonstrated colonic accumulation, one of which remains unexplained, and two accessory spleens were identified. Indium-111 leukocyte imaging is a sensitive and specific study in evaluating patients with suspected abdominal abscess. Differentiation of abscess from other causes of inflammation has not been a problem. The exact role of leukocyte imaging compared with gallium-67 citrate imaging, ultrasound and computerized tomography remains to be determined.

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

    PubMed

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

    2010-08-01

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

  15. [Possibilities of computerized tomography in the diagnosis of abscesses in the abdominal cavity and retroperitoneal space].

    PubMed

    Kishkovskiĭ, A N; Bazhanov, E A

    1987-07-01

    The article presents results of the computer tomography examination of 205 patients at different terms after operations who were clinically suspected of the development of a limited pyo-inflammatory process in the abdominal cavity or retroperitoneal space. Abscesses were revealed in 112 patients, inflammatory infiltrates in 16 patients, the development of purulent complications was excluded in 77 patients which allowed relaparotomy to be rejected in 93 patients. The computer tomography symptoms of abdominal abscesses were established. The dependence of the abscess semiotics on the stage of the suppurative process, its specific localization, intra- or extraorganic disposition, contents and size of the abscess was shown.

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

    PubMed Central

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

    2011-01-01

    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. PMID:21297925

  17. [Two-dimensional echoencephalography in focal brain pathology].

    PubMed

    Shokurov, N N; Likhterman, L B

    1976-01-01

    Two-dimentional echoencephalographic examinations were conducted in 35 patients with focal lesions of the brain of different etiology. Normal tomoechoencephalogramme and ultrasonic semiotics of transverse sections of the brain in different pathology is described with reference to its nature and interrelationships with the meninges and brain matter (tumours, abscesses, emningeal and intracerebral haematomas, hydroma, brain confusion, intracranial foreign bodies). The authors believe that two-dimentional echoencephalography is a promising method of diagnosis, free of contraindications, combinding safety and promptness of the examination. direct visualization of focal pathology of the brain through an intact skull.

  18. Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess

    PubMed Central

    Talan, David A.; Mower, William R.; Krishnadasan, Anusha; Abrahamian, Fredrick M.; Lovecchio, Frank; Karras, David J.; Steele, Mark T.; Rothman, Richard E.; Hoagland, Rebecca; Moran, Gregory J.

    2016-01-01

    BACKGROUND U.S. emergency department visits for cutaneous abscess have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). The role of antibiotics for patients with a drained abscess is unclear. METHODS We conducted a randomized trial at five U.S. emergency departments to determine whether trimethoprim–sulfamethoxazole (at doses of 320 mg and 1600 mg, respectively, twice daily, for 7 days) would be superior to placebo in outpatients older than 12 years of age who had an uncomplicated abscess that was being treated with drainage. The primary outcome was clinical cure of the abscess, assessed 7 to 14 days after the end of the treatment period. RESULTS The median age of the participants was 35 years (range, 14 to 73); 45.3% of the participants had wound cultures that were positive for MRSA. In the modified intention-to-treat population, clinical cure of the abscess occurred in 507 of 630 participants (80.5%) in the trimethoprim–sulfamethoxazole group versus 454 of 617 participants (73.6%) in the placebo group (difference, 6.9 percentage points; 95% confidence interval [CI], 2.1 to 11.7; P = 0.005). In the per-protocol population, clinical cure occurred in 487 of 524 participants (92.9%) in the trimethoprim–sulfamethoxazole group versus 457 of 533 participants (85.7%) in the placebo group (difference, 7.2 percentage points; 95% CI, 3.2 to 11.2; P<0.001). Trimethoprim–sulfamethoxazole was superior to placebo with respect to most secondary outcomes in the per-protocol population, resulting in lower rates of subsequent surgical drainage procedures (3.4% vs. 8.6%; difference, −5.2 percentage points; 95% CI, −8.2 to −2.2), skin infections at new sites (3.1% vs. 10.3%; difference, −7.2 percentage points; 95% CI, −10.4 to −4.1), and infections in household members (1.7% vs. 4.1%; difference, −2.4 percentage points; 95% CI, −4.6 to −0.2) 7 to 14 days after the treatment period. Trimethoprim–sulfamethoxazole was

  19. Tattooing: A potential novel risk factor for iliopsoas abscess.

    PubMed

    Gulati, Sweny; Jain, Ankur; Sattari, Maryam

    2014-09-16

    Iliopsoas abscess (IPA) is an uncommon infection. The clinical presentation is usually insidious. Most patients present with nonspecific symptoms, leading to difficulty in prompt and accurate diagnosis. Delay in diagnosis can lead to complications, such as sepsis and death. Tattooing has become more popular over the recent years and has been associated with tattooing-related and blood-borne infections. We present two related cases of methicillin-resistant Staphylococcus aureus IPA after tattooing and review the epidemiology, etiology, clinical features, and management of IPA. PMID:25232550

  20. Tattooing: A potential novel risk factor for iliopsoas abscess

    PubMed Central

    Gulati, Sweny; Jain, Ankur; Sattari, Maryam

    2014-01-01

    Iliopsoas abscess (IPA) is an uncommon infection. The clinical presentation is usually insidious. Most patients present with nonspecific symptoms, leading to difficulty in prompt and accurate diagnosis. Delay in diagnosis can lead to complications, such as sepsis and death. Tattooing has become more popular over the recent years and has been associated with tattooing-related and blood-borne infections. We present two related cases of methicillin-resistant Staphylococcus aureus IPA after tattooing and review the epidemiology, etiology, clinical features, and management of IPA. PMID:25232550

  1. A Case of Liver Abscess with Desulfovibrio desulfuricans Bacteremia

    PubMed Central

    Koyano, Saho; Tatsuno, Keita; Okazaki, Mitsuhiro; Ohkusu, Kiyofumi; Sasaki, Takashi; Saito, Ryoichi; Okugawa, Shu; Moriya, Kyoji

    2015-01-01

    Desulfovibrio spp. are gram-negative, sulfate-reducing, and anaerobic bacteria found in the digestive tract of humans. Because Desulfovibrio spp. are infrequent causative agents of infectious diseases and are difficult to isolate and to identify from clinical specimens, the appropriate antibiotic therapy to infection with Desulfovibrio spp. has not been determined. We report the first case of liver abscess with bacteremia due to Desulfovibrio desulfuricans to show the clinical presentation and treatment. The patient was successfully treated with intravenous piperacillin-tazobactam and oral amoxicillin-clavulanic acid. PMID:25632357

  2. Rare Dysuria: Prostatic Abscess due to Disseminated Coccidioidomycosis.

    PubMed

    Ansari Pirsaraei, Pedram; Tabsh, Kareem; Lentz, Jacob

    2016-11-01

    We present a case of disseminated coccidioidomycosis with formation of a prostatic abscess in a 28-year-old diabetic male. Though rare, Coccidiodes prostatitis should be included in the differential for patients who have spent time in endemic areas and present with prostatitis or other genitourinary tract symptoms, especially in the setting of immunocompromise. The small number of Coccidiodes prostatitis cases described in the literature previously are reviewed, along with a wider discussion of coccidioidomycosis. Treatment modalities for this challenging fungal disease are also discussed. PMID:27617214

  3. Nocardia farcinica bacteraemia presenting as a prostate abscess.

    PubMed

    Scorey, Hana; Daniel, Santhosh

    2016-01-01

    Nocardia is characterised as a Gram positive filamentous rod and is found worldwide in soil, decaying vegetable matter and aquatic environments. Localised pulmonary infection is the most common clinical presentation. However, Nocardia can present in a wide variety of clinical manifestations, especially in the immunocompromised individual. We present the first case of a prostate abscess caused by Nocardia farcinica in a man with a history of severe psoriasis and psoriatic arthritis. He had been on long term immunosuppression for this with prednisolone and etanercept. His Nocardia was likely contracted through direct skin inoculation while gardening with haematological dissemination to the prostate. He responded well to long term sulfamethoxazole and trimethoprim. PMID:27419070

  4. Spinal epidural angiolipoma complicated by an intratumoral abscess. Case report.

    PubMed

    Petrella, Gianpaolo; Tamburrini, Gianpiero; Lauriola, Libero; Di Rocco, Concezio

    2005-08-01

    Spinal angiolipomas are rare, benign lesions representing 0.14 to 1.2% of all spinal axis tumors. They most commonly involve the midthoracic spine and are located in the posterior epidural space. Up to now, six pediatric cases have been reported in the literature; two of them involved an acute clinical onset that was related to a venous infarction of a tumor. The authors report the case of a 16-year-old boy with a midthoracic epidural angiolipoma who was admitted with a clinical history of an acute paraparesis. In contrast to previous descriptions, the acute onset in this case was related to a spontaneous intratumoral abscess within the tumor.

  5. The warm sacroiliac joint. A finding in pelvic abscess

    SciTech Connect

    Slavin, J.D. Jr.; Epstein, N.; Negrin, J.A.; Spencer, R.P. )

    1990-09-01

    Two patients with pain referable to the low back and sacroiliac regions had bone scans with similar findings. In each, one sacroiliac joint was warm (uptake on that side was slightly greater than that in the contralateral area). Ga-67 imaging also demonstrated increased uptake in the same locale. Subsequent CT scanning revealed pelvic abscesses adjacent to the affected joints. Asymmetric uptake of bone imaging agent may have been related to hyperemia and heating of the sacroiliac joint. Rapid defervescence with antibiotics and drainage (and no CT evidence of bone involvement) suggested that osteomyelitis was not involved in these cases.

  6. Retroperitoneal abscess: a rare localization of tubercular infection.

    PubMed

    Karoui, Sami; Bibani, Norsaf; Ouaz, Afef; Serghini, Meriem; Chebbi, Faouzi; Nouira, Kais; Chelly, Ines; Boubaker, Jalel; Ben Safta, Zoubeir; Menif, Emna; Zitouna, Moncef; Filali, Azza

    2010-01-01

    Incidence of tuberculosis infection has considerably increased during the past 20 years due to the HIV pandemic and continues to be one of the most prevalent and deadly infections worldwide. Extrapulmonary tuberculosis lacks specific clinical manifestation and can mimic many diseases. It can invade neighbouring tissue and form a big cyst with manifesting clinical symptoms. We describe a rare case of 31-year-old immunocompetent man affected by a retroperitoneal abscess secondary to tubercular infection. Exploratory laparotomy and histopathological examinations of tissue were required for achieving diagnosis of tuberculosis. No pulmonary or spinal involvement was identified. The patient was successfully treated with standard four-drug antitubercular therapy.

  7. Infected retroperitoneal cystic lymphangioma masquerading as psoas abscess.

    PubMed

    Pratap, Akshay; Tiwari, Awadhesh; Sah, Birendra Prasad; Sinha, Arvind Kumar; Shakya, Vikal Chandra; Niels, Koopmans G

    2008-01-01

    A 2-year-old male is described who presented with fever, fixed flexion deformity of the right hip and a tender mass in the right iliac fossa. A clinical diagnosis of psoas abscess was made. Abdominal ultrasound was suggestive of an echogenic retroperitoneal cyst but could not accurately determine the nature of the cyst. A contrast CT scan showed a retroperitoneal cyst. At laparotomy, a large retroperitoneal cyst containing turbid fluid was found and was excised completely. Histopathological examination was suggestive of cystic lymphangioma. Clinical presentation of retroperitoneal lymphangioma may be variable and misleading, therefore complex imaging studies are necessary in the evaluation of this condition.

  8. Abscess formation after lip augmentation with silicone: case report.

    PubMed

    Schmidt-Westhausen, A M; Frege, J; Reichart, P A

    2004-03-01

    This paper describes the development of an abscess after injection of an alloplastic preparation (silicone) for enhancement of the lower lip. The 56-year-old woman presented with a painful swelling of her lower lip which was incised. Pus drained from the incision. A biopsy was taken. Histology revealed homogeneous foreign body inclusions (silicone) with fibrosis, chronic inflammation and multinuclear giant cells. Healing was uneventful with little deformation of the lower lip. Since the number of persons seeking aesthetic lip augmentation is increasing, oral surgeons and dentists should be familiar with adverse effects to filling agents. PMID:15050078

  9. Third branchial cleft anomaly presenting as a retropharyngeal abscess.

    PubMed

    Huang, R Y; Damrose, E J; Alavi, S; Maceri, D R; Shapiro, N L

    2000-08-31

    Branchial cleft anomalies are congenital developmental defects that typically present as a soft fluctuant mass or fistulous tract along the anterior border of the sternocleidomastoid muscle. However, branchial anomalies can manifest atypically, presenting diagnostic and therapeutic challenges. Error or delay in diagnosis can lead to complications, recurrences, and even life-threatening emergencies. We describe a case of an infected branchial cleft cyst that progressed to a retropharyngeal abscess in a 5-week-old female patient. The clinical, radiographic, and histologic findings of this rare presentation of branchial cleft cyst are discussed.

  10. Incidental Diagnosis of Appendiceal Abscess by Colonoscopy; A Case Report and Review of the Literature

    PubMed Central

    Niknam, Ramin; Fattahi, Mohammad Reza; Mahmoudi, Laleh

    2015-01-01

    Although complicated acute appendicitis is occasionally observed in general practice, the diagnosis of appendiceal abscess by colonoscopy is unusual. We report a case of appendiceal abscess with spontaneous drainage into the lumen of colon diagnosed during colonoscopy and resolved by the time of surgery. PMID:26106469

  11. Streptobacillus moniliformis as the Causative Agent in Spondylodiscitis and Psoas Abscess after Rooster Scratches▿

    PubMed Central

    Dubois, Damien; Robin, Frédéric; Bouvier, Damien; Delmas, Julien; Bonnet, Richard; Lesens, Olivier; Hennequin, Claire

    2008-01-01

    We report a case of Streptobacillus moniliformis spondylodiscitis accompanied by a psoas abscess in an 80-year-old man scratched by a rooster. S. moniliformis was identified from abscess fluid by use of 16S rRNA gene sequencing. After 18 weeks of antimicrobial therapy, the clinical condition of the patient improved. PMID:18562588

  12. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male.

    PubMed

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-03-28

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere's disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere's, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses' have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy. PMID:25834342

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

    PubMed

    Jain, Deepak; Verma, Kamal; Jain, Promil

    2014-09-01

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

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

    PubMed

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

    2013-09-01

    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.

  15. Abdominal computed tomography for postoperative abscess: is it useful during the first week?

    PubMed

    Antevil, Jared L; Egan, John C; Woodbury, Robert O; Rivera, Louis; Oreilly, Eamon B; Brown, Carlos V R

    2006-06-01

    While classic teaching dictates computed tomography (CT) for postoperative abdominal or pelvic abscess in the first week is of low yield, little evidence supports intentional delays in imaging for suspected abscess. This retrospective review examined all CT scans obtained for clinical suspicion of abscess between 3 and 30 days after abdominal or pelvic operation over a 3-year period. Scans were grouped into those obtained between 3 and 7 days after surgery (EARLY) and those obtained after day 7 (LATE). Diagnostic yield was compared between EARLY and LATE groups. Of 262 CT examinations (EARLY, n = 106; LATE, n = 156), 71 studies (27%) demonstrated abscess. There was no significant difference in the diagnostic yield of CT for abscess between EARLY and LATE groups (23% [24 of 106] versus 30% [47 of 156], P = 0.18). Of patients with an abscess, 63% (45 of 71) underwent percutaneous or operative drainage (EARLY 75% [18 of 24], LATE 57% [27 of 47], P = 0.15). Abdominal CT for postoperative abscess can be expected to be diagnostic in a substantial proportion of cases in the first week, the majority of which lead to percutaneous or operative drainage. Postoperative CT for intra-abdominal abscess should be obtained as clinically indicated, regardless of interval from surgery.

  16. [Appendiceal abscess in the third gestational trimester of pregnancy, complications pre and postoperatively].

    PubMed

    Cyrkowicz, A; Cibor, Z; Słowińska-Zabówka, M; Kisiel, W; Oleksy, P; Orczyk, K; Bajorek, M; Kwiek, G

    1996-01-01

    Delayed surgical intervention connected with misdiagnosis of preterm labour and urinary tract infection caused in gravida 3 in 34th gestational week appendiceal abscess, septic shock, stillbirth by cesarean section, necessity of hysterectomy, recidivism of multi peritoneal and pleural abscesses. Although the patient was rescued the retrospective pro memoria considerations of our procedure are regarded.

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

    PubMed

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

    2015-10-01

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

  18. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male.

    PubMed

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-03-28

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere's disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere's, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses' have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy.

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

    PubMed Central

    Pabuccu, Emre Goksan; Taskin, Salih; Atabekoglu, Cem; Sonmezer, Murat

    2014-01-01

    Severe pelvic infections following ultrasound-guided transvaginal oocyte retrieval (TVOR) are rare but challenging. Ovarian abscess formation is one of the consequences and management of such cases as highly debated in pregnant patients. In this case report, an early fetal loss following laparoscopic management of ovarian abscess is described and possible etiologies are discussed. PMID:25379164

  20. Presentation of Preauricular Sinus and Preauricular Sinus Abscess in Southwest Nigeria

    PubMed Central

    Adegbiji, W. A.; Alabi, B. S.; Olajuyin, O. A.; Nwawolo, C. C.

    2013-01-01

    BACKGROUND AND AIM: Preauricular sinus abscess is a common congenital external ear disease. This abscess is usually misdiagnosed because it is commonly overlooked during physical examination. In Nigeria, the prevalence was 9.3% in Ilorin, north central Nigeria This study is to determine the distribution and clinical presentation of the preauricular sinus abscess in Ekiti, south west Nigeria. MATERIALS AND METHODS: This is a prospective hospital based study of all patients with diagnosis of preauricular sinus abscess seen in our clinic carried out between April 2008 to March 2010. Detailed clinical history, administered interviewer’s assisted questionnaires full examination and. Data obtained were collated and analysed. RESULTS: Preauricular sinus were noticed in 184 (4.4%) out of 4170 patients seen during the study period. Preauricular sinus abscess were noticed in 21 (11.4%) of the preauricular sinuses especially in children. Unilateral preauricular sinus abscess accounted for 90.5%. Common presenting complaints were preauricular swelling (81.0%), 90.5% with recurrent earaches, 76.2% with ear discharges. All patients had antibiotic / analgesic while 17 out of 21 (81.0%) had surgical excisions. CONCLUSION: Preauricular sinus abscess were noticed among 11.4% of the preauricular sinuses especially in children, unilateral preauricular sinus abscess accounted for 90.5%. Common complaints were otorrhoea, earaches, and swelling and they were mostly managed surgically. PMID:24711764

  1. The "Penumbra Sign" on Magnetic Resonance Images of Brodie's Abscess: A Case Report.

    PubMed

    Afshar, Ahmadreza; Mohammadi, Afshin

    2011-12-01

    This report presents the "penumbra sign" of a Brodie's abscess in a 69-year-old male patient. The lesion was located in the proximal metaphysis of the left tibia. Histopathology confirmed the diagnosis of subacute osteomyelitis. The penumbra sign on magnetic resonance (MR) images is a helpful sign for the diagnosis of Brodie's abscess.

  2. Brodie's abscess. A study of 181 cases, with special reference to radiographic diagnostic criteria.

    PubMed

    Boriani, S

    1980-12-01

    A study of 181 cases of Brodie's abscess, in which the diagnosis was histologically confirmed, was made in order to demonstrate radiographic factors common to other conditions, and therefore likely to pose questions of differential diagnosis. Some of the pathological characteristics of Brodie's abscess are described and correlated with the differing radiographic appearances of this inflammatory bone lesion.

  3. Splenic abscess due to Brucella infection: is the splenectomy necessary? Case report and literature review.

    PubMed

    Del Arco, Alfonso; De La Torre-Lima, Javier; Prada, José Luís; Aguilar, Josefa; Ruiz-Mesa, Juan Diego; Moreno, Francisco

    2007-01-01

    The case of a woman with splenic abscess due to Brucella is reported. There was no response with antibiotics and surgical treatment was required. On the basis of this case and the literature review we consider that surgical treatment must be considered in patients with splenic abscess due to Brucella infection.

  4. Intra-abdominal abscess demonstrating an unusually large intra-abdominal pattern on an indium-111 leukocyte scan

    SciTech Connect

    Black, R.R.; Fernandez-Ulloa, M.; ter Penning, B.; Yellin, J.

    1988-12-01

    Indium-111 WBC imaging of a patient with occult septicemia revealed a large focal pattern of radiopharmaceutical distribution within the abdominal cavity at 24 hours post radiopharmaceutical administration. This finding was felt to represent a large intra-abdominal abscess. A five liter peritoneal abscess was found at surgery. This case illustrates an unusual presentation of an intra-abdominal abscess.

  5. Management of lactational mastitis and breast abscesses: review of current knowledge and practice.

    PubMed

    Kataria, Kamal; Srivastava, Anurag; Dhar, Anita

    2013-12-01

    Most breast abscesses develops as a complication of lactational mastitis. The incidence of breast abscess ranges from 0.4 to 11 % of all lactating mothers. The traditional management of breast abscesses involves incision and drainage of pus along with antistaphylococcal antibiotics, but this is associated with prolonged healing time, regular dressings, difficulty in breast feeding, and the possibility of milk fistula with unsatisfactory cosmetic outcome. It has recently been reported that breast abscesses can be treated by repeated needle aspirations and suction drainage. The predominance of Staphylococcus aureus allows a rational choice of antibiotic without having to wait for the results of bacteriological culture. Many antibiotics are secreted in milk, but penicillin, cephalosporins, and erythromycin, however, are considered safe. Where an abscess has formed, aspiration of the pus, preferably under ultrasound control, has now supplanted open surgery as the first line of treatment. PMID:24465097

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

    PubMed Central

    Ai, Xin-Bo; Gong, Fei-Yue; Wang, An; Liang, Hua-Min; Pan, Wen-Sheng

    2010-01-01

    Cavernous transformation of the portal vein (CTPV) is not quite common in adults, and cases with CTPV and acute liver abscess are lacking. We report a patient with CTPV inducing extrahepatic and intrahepatic obstruction, finally leading to acute liver abscess due to bile duct infection. We aim to find out the possible relationship between CTPV and acute liver abscess. A 45-year-old female patient was admitted to our hospital for recurrent upper abdominal pain and distension for one year, aggravated with fever for three years. A diagnosis of CTPV and liver abscess was made by 16-slice computed tomography. Effective antibiotics and drainage were used for this patients, and she was eventually cured. When treating patients with CTPV, extrahepatic and intrahepatic obstruction, one should be aware of the presence of acute liver abscess, and empirical antibiotics might be valuable. PMID:21060692

  7. [Psoas abscess secondary to lumbar spondylodiscitis caused by gram negative bacilli].

    PubMed

    Ampudia-Blasco, F J; Fernandez, J; Ferrer, M D; Pallardo, Y; Tenes, S; Carmena, R

    1998-08-01

    The association between psoas abscess and lumbar spondylodiscitis by Gram negative bacilli represents a rare clinical entity. Sometimes the absence of demonstrative symptoms complicates the diagnostic schema. We report about a 72 year-old woman, without previous known diabetes mellitus, who was admitted because of fever of one week duration and a non-ketotic hyperosmolar coma. A left psoas abscess was identified by abdominal computed tomography (CT). The abscess was in communication with the L1-L2 intervertebral space. Although Escherichia coli was identified as the causing agent and appropriate antibiotic therapy was administered, the resolution of the abscess occurred only after the implantation of a percutaneous catheter guided by CT without additional surgery. Percutaneous drainage as a diagnostic-therapeutic technique has rendered the surgery as the last resort in the treatment of psoas abscess. PMID:9780427

  8. Nasalseptal hematoma/abscess: management and outcome in a tertiary hospital of a developing country

    PubMed Central

    Nwosu, Jones N; Nnadede, Peter C

    2015-01-01

    Background Nasal hematoma/abscess is an uncommon entity, but capable of leading to serious consequences if not handled meticulously, and with urgency. Objective To present the management, and outcome of nasal septal hematoma/abscess in a Nigerian tertiary institution. Method Consecutive patients diagnosed with nasal septal hematoma/abscess over a 10-year period, treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria, were prospectively studied. The processes leading to diagnosis, treatment, and outcome were sequentially evaluated. Results Fifty-three patients (37 males and 16 females), age 5–65 years (with mean age of 23.10 years), were included. Surgical drainage of the hematoma/abscess, intranasal packing with insertion of drain was performed with total resolution of problem in all the cases. Conclusion Incision and drainage, and intranasal packing with insertion of drain was effective in treating nasal septal hematoma/abscess. PMID:26251577

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

    PubMed Central

    Goyal, Ankur; Madhusudhan, Kumble S; Gamanagatti, Shivanand; Baruah, Bhaskar; Shalimar; Sharma, Raju

    2016-01-01

    Hepatic artery pseudoaneurysms (HAP) are uncommon, occurring mostly as a complication of trauma (accidental or iatrogenic). Liver abscess rarely causes HAP and multiple HAP associated with cholangitic abscesses have not been reported in the literature. We present a patient of acute necrotizing pancreatitis with stent block cholangitis and multiple cholangitic abscesses who developed hemorrhagic output through drainage catheter in the liver abscess. A multiphasic CT angiography demonstrated three HAP, which were treated with a combination of endovascular coil embolization and percutaneous thrombin injection. The fact that cholangitic abscesses may be associated with pseudoaneurysms should not be neglected, considering the potentially catastrophic complication and relatively easy radiological management. CT angiography permits accurate diagnosis and lays down the roadmap for endovascular procedures. PMID:27081232

  10. Brodie's abscess following percutaneous fixation of distal radius fracture in a child.

    PubMed

    Rajakulendran, Karthig; Picardo, Natasha E; El-Daly, Ibraheim; Hussein, Rami

    2016-04-01

    We report the case of a Brodie's abscess presenting five and a half years following closed reduction and percutaneous pinning of a distal radius fracture. The index surgery was complicated by a pin site infection that was treated successfully with antibiotics. The patient represented with forearm pain years later, and radiological investigations revealed a Brodie's abscess in the distal radius at the site of the previous Kirschner wires. The Brodie's abscess was managed through surgical curettage and antibiotics. Staphylococcus aureus and diphtheroid organisms were cultured from the intraoperative specimens. A Brodie's abscess is a form of localised subacute osteomyelitis, which usually occurs in the metaphysis of long bones and can mimic malignancy. Previous trauma or surgery has been implicated as predisposing factors. We have only identified one previously reported case of Brodie's abscess following percutaneous pinning. Ours is the first reported case in an adolescent. The aim of this paper is to raise awareness of this rare complication and review the current literature.

  11. Multiple Liver Abscesses Associated with Ventriculoperitoneal Shunt Infection: Case Report and Review of the Literature

    PubMed Central

    Yang, Tae Ki

    2013-01-01

    Liver abscess following ventriculoperitoneal (VP) shunting occurs very rarely. We report an unusual case of multiple liver abscesses caused by Staphylococcus capitis in a 50-year-old compromised woman due to a complicating VP shunt infection. We reviewed the nine cases of VP shunt complications reported in the English literature, and speculated that the most likely pathogenetic mechanism in our case is an infected peritoneal tip that migrated to and penetrated the liver, which subsequently caused the formation of multiple liver abscesses. The patient was successfully treated with percutaneous aspiration, drainage of the abscesses, intravenous antibiotics, and shunt revision. Awareness and vigilance of the possibility of liver abscess formation caused by VP shunt infection will help establish an early accurate diagnosis and therapeutic strategy. PMID:24379956

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-04-01

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

  14. Cellular bases of experimental amebic liver abscess formation.

    PubMed Central

    Tsutsumi, V.; Mena-Lopez, R.; Anaya-Velazquez, F.; Martinez-Palomo, A.

    1984-01-01

    The complete sequence of morphologic events during amebic liver abscess formation in the hamster has been studied, from the lodgement of amebas in the hepatic sinusoids to the development of extensive liver necrosis. Following intraportal inoculation of live amebas, the early stages of the lesion (from 1 to 12 hours) were characterized by acute cellular infiltration composed of an increasingly large number of polymorphonuclear leukocytes, which surrounded centrally located trophozoites. Histiocytes and lysed leukocytes were situated on the periphery of the lesions. Hepatocytes close to the early lesions showed degenerative changes which led to necrosis; however, direct contact of liver cells with amebas was very rarely observed. At later stages, the extent of necrosis increased, macrophages and epithelioid cells replaced most leukocytes, and well-organized granulomas developed. Extensive necrosis associated with fused granulomas was present by Day 7. The results suggest that Entamoeba histolytica trophozoites do not produce amebic liver abscesses in hamsters through direct lysis of hepatocytes. Rather, tissue destruction is the result of the accumulation and subsequent lysis of leukocytes and macrophages surrounding the amebas. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:6385728

  15. Invasive Esophageal Candidiasis with Chronic Mediastinal Abscess and Fatal Pneumomediastinum

    PubMed Central

    Aghdam, Mohammad Reza F.; Sund, Ståle

    2016-01-01

    Patient: Male, 68 Final Diagnosis: Invasive esophageal candiasis Symptoms: Chest discomfort Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Unusual clinical course Background: Invasive candidiasis is a potential problem for patients receiving long-term immunosuppressive treatment. Psoriatic arthritis is one of many chronic diseases that can be successfully treated with immunosuppressive drugs, in spite of a documented and accepted risk for infectious complications. Critical awareness of possible infection must be part of the surveillance of such patients. Case Report: This is the case of a 68-year-old Norwegian male, treated with long-term immunosuppression for psoriatic arthritis, hospitalized with acute subcutaneous and mediastinal emphysema of unknown cause. He died of acute respiratory failure with circulatory collapse shortly after admission. The autopsy revealed mediastinal and subcutaneous emphysema and a mediastinal abscess containing Candida with probable entrance from the esophagus. Conclusions: We consider invasive candidiasis of the esophagus to be the cause of both the chronic abscess and the acute mediastinal emphysema. This case illustrates the importance of awareness of invasive candidiasis as a possible complication in a patient with long-term immunosuppression. PMID:27389822

  16. Gram staining for the treatment of peritonsillar abscess.

    PubMed

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

    2012-01-01

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

  17. Amoebic antigen in immunodiagnosis and prognosis of amoebic liver abscess.

    PubMed

    Mahajan, R C; Ganguly, N K

    1980-01-01

    The detection of amoebic antigen by counterimmunoelectrophoresis is very useful and important in the immunodiagnosis of invasive hepatic amoebiasis. The antigen was demonstrated in 115 (92%) of 125 patients with amoebic liver abscess. All the 19 cases which showed Entamoeba histolytica in the 'pus' were positive for the antigen and 96 of 106 samples negative for the parasite by smear and culture were also positive for the antigen. In none of the controls was a falsepositive reaction obtained. 12 of 13 liver biopsy specimens were also positive for antigen. The persistence or disappearance of the antigen from the liver pus biopsy specimens was investigated: the antigen disappeared in eight of the 33 cases followed for intervals up to 60 days after cure, suggesting that this is also an important additional criterion for evaluating the prognosis of the disease. Further, it has been shown that amoebic infection is followed by the appearance of specific antigen or antigenic substances in the serum which were demonstrated in 23 of 89 proved cases of amoebic liver abscess cases. Its possible role in immune complex formation and the pathogenesis of the disease is discussed. PMID:6254216

  18. Subacute splenic abscess. Appearance on indium-111 leukocyte, gallium-67, and technetium-99m sulfur colloid imaging

    SciTech Connect

    Ammann, W.; Chiu, B.K.; Wright, J.M.

    1986-03-01

    A case of a 23-year-old man with an encapsulated, anaerobic splenic abscess is reported. Both the In-111 leukocyte and Tc-99m sulfur colloid scans demonstrated an intrasplenic defect. The Ga-67 citrate scan revealed uptake in the rim of the abscess only where the abscess cavity was relatively photon-deficient. The combined Tc-99m sulfur colloid/In-111 leukocyte/Ga-67 scan appearance of a subacute splenic abscess has not been described previously. In cases suspected to be splenic abscesses the combined In-111 leukocyte/Tc-99m sulfur colloid imaging is the most useful.

  19. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male

    PubMed Central

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-01-01

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere’s disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere’s, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses’ have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy. PMID:25834342

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

    PubMed

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

    2015-11-01

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

  1. An intra-cerebral abscess in a patient with Eisenmenger syndrome: An unusual case

    PubMed Central

    Hall, Allan; White, Mark A.J.; Gallo, Pasquale

    2016-01-01

    Introduction We present an unusual case where a large intra-cerebral abscess with severe complications was treated successfully with medical management alone in a patient with Eisenmenger syndrome. Presentation of case A 40 year old patient with Eisenmenger syndrome presented with a seven day history of headache, neck pain and intermittent vomiting and fever. The only neurological examination finding was blurred vision. MRI revealed a large left occipital lobe abscess, which subsequently ruptured into the lateral ventricle with associated ventriculitis and hydrocephalus. This complicated abscess was successfully treated with intravenous antibiotics alone, with complete resolution of the abscess and hydrocephalus on MRI at 13 months post-diagnosis. Discussion Patients with congenital cyanotic heart conditions, like Eisenmenger syndrome, are at increased risk of developing intra-cerebral abscesses. Effectively managing large abscesses with associated intra-ventricular rupture and hydrocephalus in these patients without any form of surgical intervention, including aspiration, is extremely rare. Conclusion Patients with congenital cyanotic heart disease who develop large intra-cerebral abscesses with severe complications, which would normally warrant surgical intervention, have the potential to be successfully treated with antibiotics alone with excellent outcome. PMID:26859871

  2. A 10-year retrospective review of pediatric lung abscesses from a single center

    PubMed Central

    Madhani, Kavi; McGrath, Eric; Guglani, Lokesh

    2016-01-01

    INTRODUCTION: Pediatric lung abscesses can be primary or secondary, and there is limited data regarding response to treatments and patient outcomes. OBJECTIVES: To assess the clinical and microbiologic profile of pediatric patients with lung abscess and assess the differences in outcomes for patients treated with medical therapy or medical plus surgical therapy. METHODS: A retrospective review of all pediatric patients ≤ 18 years of age that were treated as an inpatient for lung abscess between the dates of August 2004 and August 2014 was conducted. Patients were divided into two subgroups based on the need for surgical intervention. RESULTS: A total of 39 patients with lung abscess (30 treated with medical therapy alone, 9 also required surgical interventions) were included. Fever, cough, and emesis were the most common presenting symptoms, and most of the patients had underlying respiratory (31%) or neurologic disorders (15%). Staphylococcus aureus was the most common organism in those that had culture results available, and ceftriaxone with clindamycin was the most common combination of antibiotics used for treatment. Comparison of medical and surgical subgroups identified the duration of fever and abscess size as risk factors for surgical intervention. CONCLUSIONS: Pediatric lung abscesses can be managed with medical therapy alone in most cases. Presence of prolonged duration of fever and larger abscess size may be predictive of the need for surgical intervention. Good clinical response to prolonged therapy with ceftriaxone and clindamycin was noted. PMID:27512508

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

    SciTech Connect

    Thanos, L. Mylona, S.; Kalioras, V.; Pomoni, M.; Batakis, Nikolaos

    2005-04-15

    Purpose. To evaluate the effectiveness of CT-guided drainage of potentially life-threatening neck abscesses. Methods. Between September 2001 and December 2003, 15 patients presented to the emergency room with potentially life-threatening neck abscesses. Their clinical condition was critical due to the abscess size (larger than 3 cm in diameter; mean diameter 5.2 cm, SD 0.91 cm) and/or abscess location. A CT scan was carried out immediately to assess the lesion. At the same time, under CT guidance, an 8 Fr trocar-type pigtail catheter was inserted, in order to drain the abscess. The decision to drain percutaneously was based on a consensus between the surgical, infectious disease and radiology teams. The catheter was kept in place until drainage stopped, and a follow-up scan was performed. Results. In 14 (93%) patients, the abscess was completely drained, and in 1 (7%) case the collection was still present because of multiple internal septation. That patient was treated by surgical management. The catheter was in place for a mean of 3 days (SD 0.96 day). Conclusion. Despite the fact that the number of our patients is small, CT-guided percutaneous drainage seems to be a fast, safe and highly effective low-cost method for the treatment of potentially life-threatening neck abscesses.

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

    PubMed

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

    2015-11-01

    Bioclimatic conditions are thought to have an impact on the frequency of dental abscesses but previous studies have suffered from small patient cohorts, methodological obstacles, and restriction to a single site resulting in limited geographic and meteorological variability. The aim of the present study was to investigate the influence of environmental temperature and barometric pressure on the frequency of dental abscesses. Three maxillofacial and two dental clinics in Vienna retrospectively provided a total of 19,218 patients with dentoalveolar abscesses who were treated by intraoral incision between 1998 and 2011. Daily records from six local meteorological stations were consulted to assess daily meteorological parameters. Univariate and multivariate hurdle count regression models were fitted to estimate the effect of daily average barometric pressure and temperature on registered abscess frequencies. Temporal confounders causing variance of the observed abscess frequencies - such as weekday, business day, and month - were taken into consideration. On days of low barometric pressure a significant rise in dental abscess frequency was observed, even when adjusting for confounders. Environmental temperature, in contrast, did not show any effect. In conclusion, bioclimatic conditions affect health as low barometric pressure increases the number of patients with dental abscesses. PMID:26346764

  5. Epizootiology of cranial abscess disease in white-tailed deer (Odocoileus virginianus) of Georgia, USA

    USGS Publications Warehouse

    Cohen, Bradley S.; Belser, Emily H.; Killmaster, Charlie H.; Bowers, John W.; Irwin, Brian J.; Yabsley, Michael J.; Miller, Karl V.

    2015-01-01

    Intracranial abscess disease is a cause of natural mortality for mature male white-tailed deer (Odocoileus virginianus). Most cases of abscesses are associated with bacterial infection byTrueperella (Arcanobacterium) pyogenes, but a complete understanding of the epidemiology of this disease is lacking. We quantified the effects of individual characteristics, site-specific herd demographics, land cover, and soil variables in estimating the probability of this disease. We examined 7,545 white-tailed deer from 60 sites throughout Georgia US for signs of cranial abscesses, the predecessor of intracranial abscesses, and recorded the presence or absence of cranial abscesses for each individual examined. We detected no cranial abscesses in 2,562 female deer but 91 abscesses in 4,983 male deer examined (1.8%). A generalized linear mixed model, treating site as a random effect, was used to examine several potential explanatory risk factors including site-level landscape and soil characteristics (soil and forest type), demographic factors (deer density and male to female ratio), and individual host factors (deer sex and age). Model results indicated that the probability of a male having a cranial abscess increased with age and that adult sex ratio (male:female) was positively associated with this disease. Site-specific variables for land cover and soil types were not strongly associated with observations of the disease at the scale measured and a large amount of among-site variability remained. Given the demonstrated effect of age, gender, and local sex ratios but the remaining unexplained spatial variability, additional investigation into spatiotemporal variation of the presumed bacterial causative agent of cranial abscesses appears warranted.

  6. EPIZOOTIOLOGY OF CRANIAL ABSCESS DISEASE IN WHITE-TAILED DEER (ODOCOILEUS VIRGINIANUS) OF GEORGIA, USA.

    PubMed

    Cohen, Bradley S; Belser, Emily H; Killmaster, Charlie H; Bowers, John W; Irwin, Brian J; Yabsley, Michael J; Miller, Karl V

    2015-07-01

    Intracranial abscess disease is a cause of natural mortality for mature male white-tailed deer (Odocoileus virginianus). Most cases of abscesses are associated with bacterial infection by Trueperella (Arcanobacterium) pyogenes, but a complete understanding of the epidemiology of this disease is lacking. We quantified the effects of individual characteristics, site-specific herd demographics, land cover, and soil variables in estimating the probability of this disease. We examined 7,545 white-tailed deer from 60 sites throughout Georgia US for signs of cranial abscesses, the predecessor of intracranial abscesses, and recorded the presence or absence of cranial abscesses for each individual examined. We detected no cranial abscesses in 2,562 female deer but 91 abscesses in 4,983 male deer examined (1.8%). A generalized linear mixed model, treating site as a random effect, was used to examine several potential explanatory risk factors including site-level landscape and soil characteristics (soil and forest type), demographic factors (deer density and male to female ratio), and individual host factors (deer sex and age). Model results indicated that the probability of a male having a cranial abscess increased with age and that adult sex ratio (male:female) was positively associated with this disease. Site-specific variables for land cover and soil types were not strongly associated with observations of the disease at the scale measured and a large amount of among-site variability remained. Given the demonstrated effect of age, gender, and local sex ratios but the remaining unexplained spatial variability, additional investigation into spatiotemporal variation of the presumed bacterial causative agent of cranial abscesses appears warranted.

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

    PubMed Central

    Kern, Philip A

    2016-01-01

    Summary Pituitary abscess is a relatively uncommon cause of pituitary hormone deficiencies and/or a suprasellar mass. Risk factors for pituitary abscess include prior surgery, irradiation and/or pathology of the suprasellar region as well as underlying infections. We present the case of a 22-year-old female presenting with a spontaneous pituitary abscess in the absence of risk factors described previously. Her initial presentation included headache, bitemporal hemianopia, polyuria, polydipsia and amenorrhoea. Magnetic resonance imaging (MRI) of her pituitary showed a suprasellar mass. As the patient did not have any risk factors for pituitary abscess or symptoms of infection, the diagnosis was not suspected preoperatively. She underwent transsphenoidal resection and purulent material was seen intraoperatively. Culture of the surgical specimen showed two species of alpha hemolytic Streptococcus, Staphylococcus capitis and Prevotella melaninogenica. Urine and blood cultures, dental radiographs and transthoracic echocardiogram failed to show any source of infection that could have caused the pituitary abscess. The patient was treated with 6weeks of oral metronidazole and intravenous vancomycin. After 6weeks of transsphenoidal resection and just after completion of antibiotic therapy, her headache and bitemporal hemianopsia resolved. However, nocturia and polydipsia from central diabetes insipidus and amenorrhoea from hypogonadotrophic hypogonadism persisted. Learning points Pituitary abscesses typically develop in patients who have other sources of infection or disruption of the normal suprasellar anatomy by either surgery, irradiation or pre-existing pathology; however, they can develop in the absence of known risk factors. Patients with pituitary abscesses typically complain of headache, visual changes and symptoms of pituitary hormone deficiencies. As other pituitary neoplasms present with similar clinical findings, the diagnosis of pituitary abscess is often not

  8. Antibiotic Abscess Penetration: Fosfomycin Levels Measured in Pus and Simulated Concentration-Time Profiles

    PubMed Central

    Sauermann, Robert; Karch, Rudolf; Langenberger, Herbert; Kettenbach, Joachim; Mayer-Helm, Bernhard; Petsch, Martina; Wagner, Claudia; Sautner, Thomas; Gattringer, Rainer; Karanikas, Georgios; Joukhadar, Christian

    2005-01-01

    The present study was performed to evaluate the ability of fosfomycin, a broad-spectrum antibiotic, to penetrate into abscess fluid. Twelve patients scheduled for surgical or computer tomography-guided abscess drainage received a single intravenous dose of 8 g of fosfomycin. The fosfomycin concentrations in plasma over time and in pus upon drainage were determined. A pharmacokinetic model was developed to estimate the concentration-time profile of fosfomycin in pus. Individual fosfomycin concentrations in abscess fluid at drainage varied substantially, ranging from below the limit of detection up to 168 mg/liter. The fosfomycin concentrations in pus of the study population correlated neither with plasma levels nor with the individual ratios of abscess surface area to volume. This finding was attributed to highly variable abscess permeability. The average concentration in pus was calculated to be 182 ± 64 mg/liter at steady state, exceeding the MIC50/90s of several bacterial species which are commonly involved in abscess formation, such as streptococci, staphylococci, and Escherichia coli. Hereby, the exceptionally long mean half-life of fosfomycin of 32 ± 39 h in abscess fluid may favor its antimicrobial effect because fosfomycin exerts time-dependent killing. After an initial loading dose of 10 to 12 g, fosfomycin should be administered at doses of 8 g three times per day to reach sufficient concentrations in abscess fluid and plasma. Applying this dosing regimen, fosfomycin levels in abscess fluid are expected to be effective after multiple doses in most patients. PMID:16251282

  9. EPIZOOTIOLOGY OF CRANIAL ABSCESS DISEASE IN WHITE-TAILED DEER (ODOCOILEUS VIRGINIANUS) OF GEORGIA, USA.

    PubMed

    Cohen, Bradley S; Belser, Emily H; Killmaster, Charlie H; Bowers, John W; Irwin, Brian J; Yabsley, Michael J; Miller, Karl V

    2015-07-01

    Intracranial abscess disease is a cause of natural mortality for mature male white-tailed deer (Odocoileus virginianus). Most cases of abscesses are associated with bacterial infection by Trueperella (Arcanobacterium) pyogenes, but a complete understanding of the epidemiology of this disease is lacking. We quantified the effects of individual characteristics, site-specific herd demographics, land cover, and soil variables in estimating the probability of this disease. We examined 7,545 white-tailed deer from 60 sites throughout Georgia US for signs of cranial abscesses, the predecessor of intracranial abscesses, and recorded the presence or absence of cranial abscesses for each individual examined. We detected no cranial abscesses in 2,562 female deer but 91 abscesses in 4,983 male deer examined (1.8%). A generalized linear mixed model, treating site as a random effect, was used to examine several potential explanatory risk factors including site-level landscape and soil characteristics (soil and forest type), demographic factors (deer density and male to female ratio), and individual host factors (deer sex and age). Model results indicated that the probability of a male having a cranial abscess increased with age and that adult sex ratio (male:female) was positively associated with this disease. Site-specific variables for land cover and soil types were not strongly associated with observations of the disease at the scale measured and a large amount of among-site variability remained. Given the demonstrated effect of age, gender, and local sex ratios but the remaining unexplained spatial variability, additional investigation into spatiotemporal variation of the presumed bacterial causative agent of cranial abscesses appears warranted. PMID:25984774

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

    PubMed

    Jalaludin, M A

    1993-10-01

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

  11. Appendicitis and uterine abscess: presentation of an unusual fistula between the gynaecological and gastrointestinal tracts

    PubMed Central

    Parsons, Sian Ruth; Bennett, Joanne Elizabeth; Kaloo, Philip; Scott, Mike

    2012-01-01

    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

  12. Emergent Airway Management of an Uncooperative Child with a Large Retropharyngeal and Posterior Mediastinal Abscess.

    PubMed

    Diep, Jack; Kam, David; Kuenzler, Keith A; Arthur, Jill F

    2016-02-01

    Retropharyngeal abscesses are deep neck space infections that can lead to life-threatening airway emergencies and other catastrophic complications. Retropharyngeal abscesses demand prompt diagnosis and early establishment of a definitive airway when there is airway compromise. This can be difficult in an uncooperative patient. We present the case of a 12-year-old girl with mediastinitis and tracheal compression and anterior displacement from a large retropharyngeal and posterior mediastinal abscess secondary to traumatic esophageal perforation, who received successful awake nasal fiberoptic intubation. Anesthesiologists must be prepared for airway emergencies in uncooperative patients, especially children, but there is controversy concerning the use of sedation. PMID:26599735

  13. Detection of circulating antigen in amoebic liver abscess by counter-current immunoelectrophoresis.

    PubMed

    Parija, S C; Karki, B M

    1999-01-01

    Fifty serum samples from patients with amoebic liver abscess and 50 from subjects who had not suffered from the disease (25 from patients with other, chiefly parasitic, infections and 25 from healthy blood donors, staff or students) were tested for circulating amoebic antigen by counter-current immuno-electrophoresis (CIEP). Amoebic antigen was detected in 38 sera (76%) from cases of amoebic liver abscess, but in none of the other sera. Although CIEP is only moderately sensitive, the high specificity suggests that this simple test may be useful in the diagnosis of amoebic liver abscess.

  14. Bursae and abscess cavities communicating with the hip: diagnosis using arthrography and CT

    SciTech Connect

    Steinbach, L.S.; Schneider, R.; Goldman, A.B.; Kazam, E.; Ranawat, C.S.; Ghelman, B.

    1985-08-01

    Bursae or abscess cavities communicating with the hip joint were demonstrated by hip arthrography or by computed tomography (CT) in 40 cases. The bursae or abscess cavities were associated with underlying abnormalities in the hip, including painful hip prostheses, infection, and inflammatory or degenerative arthritis. Symptoms may be produced directly as a result of infection or indirectly as a result of inflammation or pressure on adjacent structures. Hip arthrography can confirm a diagnosis of bursae and abscess cavities communicating with the hip joint in patients with hip pain or soft-tissue masses around the groin. Differentiation of enlarged bursae from other abnormalities is important to avoid unnecessary or incorrect surgery.

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

    PubMed

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

    2012-12-01

    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever. PMID:23199723

  16. Splenic abscess due to fungal infection after kidney transplantation; a case report

    PubMed Central

    Malakoutian, Tahereh; Yarmohamadi, Maliheh; Mohammadi, Ronak; Asgari, Mojgan; Mahmoodian, Reyhaneh

    2016-01-01

    Splenic abscess is one of the rare and potentially life-threatening complications after kidney transplantation. Splenic abscess generally occurs in patients who have immunodeficiency state. It becomes more important with the increased use of immunosuppressed drugs and organ transplantation. The clinical presentation of splenic abscess is insidious, often with constitutional symptoms. Left upper quadrant tenderness is an uncommon sign. Therefore, its diagnosis is difficult and requires a high degree of clinical suspicion. We report a case under renal transplantation with recurrent fungal infection in different organs with two episodes of fungemia who died after splenectomy. PMID:27689116

  17. Splenic abscess due to fungal infection after kidney transplantation; a case report.

    PubMed

    Malakoutian, Tahereh; Yarmohamadi, Maliheh; Mohammadi, Ronak; Asgari, Mojgan; Mahmoodian, Reyhaneh

    2016-01-01

    Splenic abscess is one of the rare and potentially life-threatening complications after kidney transplantation. Splenic abscess generally occurs in patients who have immunodeficiency state. It becomes more important with the increased use of immunosuppressed drugs and organ transplantation. The clinical presentation of splenic abscess is insidious, often with constitutional symptoms. Left upper quadrant tenderness is an uncommon sign. Therefore, its diagnosis is difficult and requires a high degree of clinical suspicion. We report a case under renal transplantation with recurrent fungal infection in different organs with two episodes of fungemia who died after splenectomy. PMID:27689116

  18. Brodie's abscess of the proximal femoral epiphysis in an adult woman with systemic lupus erythematosus.

    PubMed

    Miyanishi, Keita; Yamamoto, Takuaki; Irisa, Takahiko; Jingushi, Seiya; Noguchi, Yasuo; Iwamoto, Yukihide

    2002-06-01

    We report an unusual case of pathologically proved femoral head Brodie's abscess mimicking avascular necrosis of bone in a 51-year-old woman with a 2-year history of corticosteroid treatment for systemic lupus erythematosus. On plain radiographs, a rounded lucency and thin sclerotic margins together with subchondral collapse and a lytic region were observed in the femoral head. The histopathologic examination revealed a central abscess formation surrounded by fibrous tissue with the aggregation of neutrophils and plasma cells. To our knowledge, this is the first case report describing a Brodie's abscess which had developed within the proximal femoral epiphysis in an adult.

  19. Paravertebral abscess by Escherichia coli and melanoma metastasis in an older woman.

    PubMed

    dos Santos, Vitorino Modesto; Passini, Viviane Vieira; Gebrim, Daniela Gomes; Flores, Leandro Pretto; Silva, Renata Faria; da Cruz Silva, Samuel Abner

    2015-12-01

    Paravertebral abscesses are usually caused by Staphylococcus aureus, and often affect older people with diabetes mellitus or immunosuppression. We report a huge lumbar abscess caused by Escherichia coli in an 81-year-old woman with diabetes and melanoma metastasis. Lumbar vertebra and surrounding soft tissues were involved by the Gram-negative infection, and imaging features were indicative of malignant condition. Diagnosis was established by images of magnetic resonance, histopathology, and bacterial culture from abscess fluid. This condition poses diagnosis challenges and seems to be increasing in frequency. Reports of case studies might enhance the suspicion index of primary care physicians about this entity. PMID:26700088

  20. Cervical spondylitis and spinal abscess due to Actinomyces meyeri.

    PubMed

    Duvignaud, Alexandre; Ribeiro, Emmanuel; Moynet, Daniel; Longy-Boursier, Maïté; Malvy, Denis

    2014-01-01

    Human actinomycosis with involvement of the spine is a rare condition although it has been first described a long time ago. It is probably underrecognized since its clinical presentation is often misleading and accurate bacteriological diagnosis is challenging. We herein report a rare case of cervical actinomycosis with paravertebral abscess and spondylitis imputed to an infection by Actinomyces meyeri in a 52-year-old immunocompetent Caucasian man. A. meyeri should be considered as a potential cause for subacute or chronic spondylitis, even in immunocompetent subjects. Modern diagnostic tools such as Matrix-Assisted Laser Desorption-Ionization Time of Flight mass spectrometry and 16S rRNA sequencing are efficient for accurate microbiological identification.

  1. Spinal epidural abscess in a young girl without risk factors.

    PubMed

    Mantadakis, Elpis; Birbilis, Theodosios; Michailidis, Lambros; Souftas, Vasileios; Chatzimichael, Athanassios

    2011-07-01

    Spinal epidural abscess (SEA) is a rare infection associated with well-established risk factors mainly in adults. We describe an 11-year-old girl without any known risk factors who presented with fever and localized spinal tenderness in the lumbar area and was diagnosed with spinal MRI as suffering from a posterior SEA extending between T11 and L4. She was successfully managed with sequential intravenous and oral antibiotics along with minimally invasive surgery without laminectomy. Methicillin-sensitive Staphylococcus aureus was the responsible pathogen isolated at surgery. Immediate institution of antibiotics, spinal MRI, and well-timed neurosurgical consultation are mandatory for a favorable outcome in cases of SEA in children. PMID:21360025

  2. Leg ulcers and abscesses caused by Serratia marcescens.

    PubMed

    Langrock, Marie-Luise; Linde, Hans-Jörg; Landthaler, Michael; Karrer, Sigrid

    2008-01-01

    Cutaneous infections caused by S. marcescens, a gram-negative bacillus belonging to the family of Enterobacteriaceae, are uncommon but may be predisposed by immunocompromised conditions or pre-damaged skin. A 73-year-old man presented with multiple ulcers and painful nodules on the lower right leg as well as abscesses on the right malleolus lateralis. He had been treated with oral penicillin without success. Due to chronic obstructive pulmonary disease, he was receiving a systemic therapy with corticosteroids. In addition, he had a post-thrombotic syndrome of the lower right leg. Serratia marcescens was the only microorganism isolated from all cultures performed. After a microbial sensitivity test, ertapenem 1 g/day was given intravenously for 10 days, followed by oral administration of ciprofloxacin 500 mg 1-0-1 for a further 7 days. This therapy resulted in the resolution of all lesions. This rare skin infection with S. marcescens needs specific microbiological diagnosis and adapted antibiosis.

  3. Percutaneous Management of Abscess and Fistula Following Pancreaticoduodenectomy

    SciTech Connect

    AAssar, O. Sami; LaBerge, Jeanne M.; Gordon, Roy L.; Wilson, Mark W.; Mulvihill, Sean J.; Way, Lawrence W.; Kerlan, Robert K.

    1999-01-15

    Purpose: To evaluate the efficacy of percutaneous drainage of fluid collections following pancreaticoduodenectomy (Whipple's procedure). Methods: We performed a retrospective review of 19 patients referred to our service with fluid collections following pancreaticoduodenectomy. The presence of associated enteric or biliary fistulas, the route(s) of access for image-guided drainage, the incidence of positive bacterial cultures, and the duration and success of percutaneous management were recorded. Results: Fistulous communication to the jejunum in the region of the pancreatico-jejunal anastomosis was demonstrable in all 19 patients by gentle contrast injection into drainage tubes. Three patients had concurrent biliary fistulas. In 18 of 19 patients, fluid samples yielded positive bacterial cultures. Successful percutaneous evacuation of fluid was achieved in 17 of 19 patients (89%). The mean duration of drainage was 31 days. Conclusion: Percutaneous drainage of abscess following pancreaticoduodenectomy is effective in virtually all patients despite the coexistence of enteric and biliary fistulas.

  4. Maxillary odontogenic sinusitis, complicated with cerebral abscess--case report.

    PubMed

    Onişor-Gligor, F; Lung, T; Pintea, B; Mureşan, O; Pop, P B; Juncar, M

    2012-01-01

    Maxillary sinus inflammation, when untreated or incorrectly treated, may extend locoregionally, the remaining paranasal sinuses being the first affected anatomical structures. This is why the understanding of the inflammatory pathology of the maxillary sinus, and particularly of the complications it can generate, is extremely important. The purpose of this presentation is to point out that inflammations of the paranasal sinuses are susceptible to develop complications in certain conditions and threaten the patient's life due to the proximity of vital structures. This is the case of a 16 years old male patient who developed a left maxillary and frontal sinusitis, complicated with cerebral abscess. Early detection, multidisciplinary approach and proper indication of surgical treatment, as well as early suspicion of complication, especially in young male adolescents, are extremely important.

  5. Purulent Pericarditis after Liver Abscess: A Case Report

    PubMed Central

    Fidalgo García, María; Rodríguez Sanjuán, Juan Carlos; Riaño Molleda, María; González Andaluz, Marta; Real Noval, Hector; Gómez Fleitas, Manuel

    2014-01-01

    We present the case of a 49-year-old woman, with previous clinical antecedents of recent hepatic metastasis, who was admitted to the ICU due to respiratory failure and hemodynamic instability. She was found to have purulent pericarditis complicated by pericardial tamponade and pleural effusion, as well as surgical site infection, which was the origin of the disease. Cultures of the surgical wound and the pericardial effusion were positive for Enterococcus faecalis and Escherichia coli. A pericardial tap was performed and the intra-abdominal abscess was surgically drained. Pleural effusion was also evacuated. She received antibiotic treatment and recovered successfully. The only after-effect was a well-tolerated effusive-constrictive pericarditis. PMID:24872819

  6. Unusual presentation of filariasis as an abscess: A case report.

    PubMed

    Ahuja, Mukta; Pruthi, Sonam Kumar; Gupta, Renu; Khare, Pratima

    2016-01-01

    Bancroftian filariasis, a tropical and subtropical disease caused by Wuchereria bancrofti, is transmitted by the culex mosquito. The disease is conventionally diagnosed by the demonstration of microfilaria in peripheral blood smear. Microfilaria and adult filarial worms have been incidentally detected in fine needle aspiration cytology (FNAC) in various locations. The disease may be missed if one is not aware of the possibility, particularly in cases where eosinophilia is absent. Therefore, clinicians and pathologists need to be more vigilant in the endemic zones for early diagnosis and the treatment of filariasis. We report here an unusual case of filariasis in a 17-year-old female with a swelling in the lower part of the left arm on the flexor surface. This highlights the chances of finding microfilaria in cytology of an unsuspected case at an unusual site. This case, in addition, stresses the fact that microfilaria may be associated with an abscess even in the absence of eosinophilia. PMID:27011444

  7. Lipoprotein lipase deficiency presenting with neonatal perianal abscesses.

    PubMed

    Akesson, Lauren S; Burnett, John R; Mehta, Divyesh K; Martin, Andrew C

    2016-01-01

    Lipoprotein lipase (LPL), a member of the triglyceride lipase gene family, is synthesised by parenchymal cells of the heart, skeletal muscle and adipose tissues before being transported to luminal surfaces of vascular endothelial cells to exert its main physiological function to hydrolyse plasma lipoproteins. LPL deficiency is a rare autosomal recessive disorder, resulting in severe hypertriglyceridaemia from birth. The effect of marked hypertriglyceridaemia on the immune function in children has not been described. We present a case of a neonate with LPL deficiency and grossly elevated plasma triglyceride levels, presenting with recurrent and recalcitrant perianal abscesses suggestive of underlying immunodeficiency. With reduced levels of plasma triglycerides, the recurrent perianal infections resolved. This case report reviews evidence for potential deleterious effects of hypertriglyceridaemia on immune function, however, underlying mechanisms are poorly understood. Whether hypertriglyceridaemia contributes to immune dysfunction in this context is unknown. If there is a pathophysiological link, this may have implications for hypertriglyceridaemia management. PMID:26825936

  8. Bacillary angiomatosis presenting with facial tumor and multiple abscesses

    PubMed Central

    Markowicz, Mateusz; Käser, Stephanie; Müller, Andreas; Lang, Gerold; Lang, Susanna; Mayerhöfer, Marius; Stanek, Gerold; Rieger, Armin

    2016-01-01

    Abstract Background: The clinical manifestation of bacillary angiomatosis (BA) can be limited to one organ, most commonly the skin, but systemic courses can also occur. We report a human immunodeficiency virus (HIV)-positive patient with a systemic manifestation of BA caused by Bartonella quintana, diagnosed in Vienna, Austria. The pathogen was detected in multiple organs including a facial tumor which is an unusual finding for BA. Furthermore, infections with B quintana are rare in our area and no other autochthonous cases have been reported. Methods and results: The clinical manifestation included multiple papules and nodules on the entire body, several organic abscesses, and a facial tumor influencing the patient's view. The main laboratory finding indicated HIV infection combined with severe immunosuppression with 47 CD4+ cells/μL. Contrast-enhanced computed tomography of the chest and the abdomen showed multiple and abscesses. Histological examination of the facial tumor confirmed inflammatory process. Bartonella quintana was detected by PCR in blood and in the facial tumor as well as by culture in the skin tissue. Antibiotic treatment with doxycycline and antiretroviral therapy resulted in clinical improvement. Conclusion: Our case shows that rare opportunistic, vector-borne infections, usually associated with poverty, can lead to diagnosis of HIV even in well-developed countries. Furthermore, we provide details on clinical manifestation and diagnostic work-up which might expand the knowledge on disseminated infections with B quintana. As far, tumorous deformations have rarely been reported as consequence of BA. In our patient the pathogen was detected in the facial tumor using PCR techniques. PMID:27428207

  9. [Clinical Analyses of 115 Patients with Peritonsillar Abscess].

    PubMed

    Umibe, Akiko; Anazawa, Utaro; Kessoku, Hisashi; Takaishi, Shinya; Hachisu, Takuya; Masuda, Ayako; Yoshimura, Tsuyoshi; Iino, Takashi; Tanaka, Yasuhiro

    2015-10-01

    The clinical data of 115 patients with peritonsillar abscess (98 men and 17 women) treated between May 2011 and March 2014 were analyzed. We examined 9 items; the age, sex, affected side, duration of hospitalization, method of drainage, smoking history, history of diabetes, antibacterial drugs used, and the isolated bacteria. The disease predominantly affected males in their 30s (27.8% of all the patients). The median duration of hospitalization was 7 days. In regard to the affected side, the right side was affected in 52%, the left side in 44%, and both sides in 4%. The method of drainage used was incision in 63%, and puncture in 37%. In regard to the personal and past medical history, 51% of patients had a history of smoking and 3.5% had a history of diabetes. ABPC/SBT was used as the single-agent antibacterial drug in 75% of cases. The most commonly isolated aerobic bacteria were α-hemolytic streptococci, and the most commonly isolated anaerobic bacteria were Prevotella. The duration of hospitalization showed no significant correlation with the smoking history, drainage method or the antibiotic treatment used (ABPC/SBT single-agent or multiple drug use). On the other hand, the duration of hospitalization was significantly longer in the more than ≥65 years' age group than in the <65 years' age group. Therefore, especially careful interventions for prevention and treatment of peritonsillar abscess are required in the elderly. In relation to antibiotic selection, it may be reasonable to expect sufficient effect with the use of ABPC/SBT as a single agent, as this antibiotic has a broad antibacterial spectrum covering aerobic, anaerobic and drug-resistant bacteria. PMID:26727821

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

    PubMed

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

    2013-07-17

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

  11. Paraspinal and Extensive Epidural Abscess: The Great Masqueraders of Abdominal Pain.

    PubMed

    Chu, Andrew; Aung, Thu Thu; Shankar, Uday

    2015-01-01

    Paraspinal and epidural abscesses are rare conditions often diagnosed later in the disease process that can have significant morbidity and mortality. Predisposing risk factors include diabetes, human immunodeficiency virus, intravenous drug abuse, and previous history of spinal surgery or injection. They can threaten the spinal cord by compressive effect, leading to sensory motor deficits and ultimately paralysis and death. Diagnosis may be a challenge due to the delayed presentation of nonspecific back pain or radicular pain such as chest pain or abdominal pain. We present a rare case on a patient with periumbilical pain, constipation, and urinary retention who was ultimately diagnosed with a paraspinal abscess extending into the epidural space from T1 to S2. He underwent decompressive laminectomy with incision and drainage of the abscesses. The patient made an excellent recovery postoperatively, and repeat magnetic resonance imaging at six weeks showed resolution of the abscess. PMID:26770847

  12. Subdiaphragmatic abscesses: myths and realities. A report on sixty-two cases.

    PubMed

    Haluk, G I; Ismail, K; Salim, D; Levent, B; Hünkar, K

    1991-01-01

    The main cause (60.8%) of subdiaphragmatic abscesses in a series of 62 patients (of which 46 were males), was found to be hepatobiliary in nature. Radiology proved to be helpful in correct diagnosis (61%), as did ultrasonography (60%). Right sided subdiaphragmatic abscesses were (55/62) 88.7% of the total. Mean abscess volume was 500 ml while culturing efforts were in vain in 32% of the abscess cases (able to be cultured). The incidence of morbidity was (12/62) 19.4% and mortality (3/62) 4.8% in this series, where the treatment was solely through surgical drainage. Though closed drainage using ultrasonic guidance has been popular in the past decade, it has its drawbacks. Open surgical drainage therefore, as a well established mode of treatment, is recommended. PMID:1869394

  13. Specific but limited role of new imaging techniques in decision-making about intraabdominal abscesses

    SciTech Connect

    Wright, H.K.; Dunn, E.; MacArthur, J.D.; Pelliccia, O.

    1982-04-01

    Despite the very high accuracy rate of imaging studies (ultrasound, computed tomography, liver-lung-spleen scans and /sup 67/Ga scans) in detecting intraabdominal abscesses, our experience with 80 recent cases indicate that these techniques have not significantly altered traditional methods of decision-making about when and where to drain such abscesses. In only 12.5 percent of cases were such decisions based on special imaging techniques alone, and most of these cases subphrenic abscesses were diagnosed late after surgery. In the remainder, physical examination and routine radiologic studies sufficed, with special imaging techniques primarily corroborating clinical evidence based on these methods. We conclude that the use of special imaging techniques alone in a search for the cause of fever early after abdominal surgery does not provide evidence upon which clinical decisions can be based unless there are already physical signs of an abscess.

  14. Herpes zoster ophthalmicus presenting as orbital abscess along with superior orbital fissure syndrome: A case report.

    PubMed

    Lavaju, Poonam; Badhu, Badri Prasad; Shah, Sangeeta

    2015-09-01

    Orbital abscess and superior orbital fissure syndrome (SOFS) are rare manifestations of herpes zoster ophthalmicus. Herein, we report a case of orbital abscess along with SOFS in a 2.5-year-old-male child secondary to herpes zoster infection. He presented with a 5-day history of proptosis and ptosis of the right eye that had been preceded by vesicular eruptions on the right forehead and scalp. Computed tomography scan of the head and orbit showed orbital abscess and right cavernous sinus thrombosis. A diagnosis of orbital abscess with SOFS secondary to herpes infection was made. The condition subsequently improved following antiviral therapy, intravenous vancomycin and amikacin, and oral corticosteroids. PMID:26632131

  15. [Clinical study of iliopsoas abscess in 11 cases from 2005 to 2008].

    PubMed

    Tate, Hideki

    2009-11-01

    Iliopsoas abscess, a rare disease, has shown a recent alarming increase in the number of patients, especially among older people. This clinical study of iliopsoas abscess in 11 cases seen from 2005 to 2008, showed the average age of patients to be 76 years-higher than the average. Causes were often orthopedic diseases such as pyogenic spondylitis. The four most commonly recognized underlying diseases were spinal, including lumbar spinal canal stenosis and lumbar disc herniation. Antibiotic induced a cure in only 6 of 11 cases. In this conservatively treated group, average abscess diameter was significantly smaller than in the non conservatively treated group. Conservative treatment thus requires that such abscess be detected as early as possible.

  16. Paraspinal and Extensive Epidural Abscess: The Great Masqueraders of Abdominal Pain

    PubMed Central

    Chu, Andrew; Aung, Thu Thu; Shankar, Uday

    2015-01-01

    Paraspinal and epidural abscesses are rare conditions often diagnosed later in the disease process that can have significant morbidity and mortality. Predisposing risk factors include diabetes, human immunodeficiency virus, intravenous drug abuse, and previous history of spinal surgery or injection. They can threaten the spinal cord by compressive effect, leading to sensory motor deficits and ultimately paralysis and death. Diagnosis may be a challenge due to the delayed presentation of nonspecific back pain or radicular pain such as chest pain or abdominal pain. We present a rare case on a patient with periumbilical pain, constipation, and urinary retention who was ultimately diagnosed with a paraspinal abscess extending into the epidural space from T1 to S2. He underwent decompressive laminectomy with incision and drainage of the abscesses. The patient made an excellent recovery postoperatively, and repeat magnetic resonance imaging at six weeks showed resolution of the abscess. PMID:26770847

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

    PubMed

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

    2007-10-01

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

  18. Pontine abscess with initial treatment failure following infectious endocarditis with Streptococcus salivarius.

    PubMed

    Knudtzen, Fredrikke Christie; Lynge, Maja; Gaini, Shahin

    2015-01-01

    We present a case report of a 65-year-old man admitted to the department of infectious diseases on suspicion of meningitis with headache, fever and double vision. A cerebral MRI revealed a 17×30 mm pontine abscess with surrounding oedema. The patient had, 2 months prior to admission, been treated for Streptococcus salivarius aortic valve endocarditis. The abscess was not suitable for surgery, and the patient received multidrug antibiotic treatment for 4 weeks. The patient initially responded well clinically, but was readmitted 4 weeks after discontinuation of treatment, with headache and dizziness. A new cerebral MRI showed progression of the abscess. He received an additional 8 weeks of broad spectrum antibiotic treatment, followed by 12 weeks of oral treatment with pivampicillin. His symptoms resolved and a cerebral MRI at discontinuation of treatment showed regression of the abscess to 7.5 mm. PMID:26139646

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

    PubMed Central

    Pangonis, Scott; Patamasucon, Pisespong; Fitzpatrick, Ellen

    2016-01-01

    Streptococcus pneumoniae is an invasive organism that causes a wide range of common diseases, including sinusitis, acute otitis media, and pneumonia. Splenic abscesses and purpura fulminans (PF) are rare complications of pneumococcal disease. Splenic abscesses caused by S pneumoniae have only been reported in the adult literature. PF has been described in the pediatric population as a rare complication in patients with invasive pneumococcal disease (IPD) with and without underlying immunological disorders such as asplenia. Here, we report a patient with IPD complicated by splenic abscesses and PF. Our patient initially presented with bacteremia, septic shock, and disseminated intravascular coagulation. She subsequently developed PF and splenic abscesses. She survived her illness after receiving a total of 8 weeks of antibiotic therapy. This case highlights 2 rare complications of IPD and demonstrates the need to keep pneumococcal disease in the differential diagnosis even in children whose vaccination status is up to date. PMID:27006958

  20. Recurrent retroperitoneal abscess due to perforated colonic diverticulitis in a patient with polycystic kidney disease.

    PubMed

    Li, Szu-Yuan; Jiang, Jeng-Kai; Chang, Yen-Hwa; Wu, Te-Chang; Yang, Wu-Chang; Ng, Yee-Yung

    2009-03-01

    Patients with autosomal dominant polycystic kidney disease (ADPKD) usually have extrarenal manifestations. We report the case of a 53-year-old man with ADPKD who presented with a retroperitoneal abscess of the left side after undergoing bilateral nephrectomy for a cyst that had repeatedly bled for 1 year. The abscess recurred despite drainage with a pig-tail catheter and antibiotic treatment. Fistulography with injection of diluted contrast medium via the pig-tail catheter showed an accumulation of contrast medium in the descending colon, which indicated a fistula between the abscess and the descending colon. A portion of the descending colon was resected, and multiple diverticulitis with 1 perforation in the resected specimen was observed. The findings support a diagnosis of retroperitoneal abscess caused by a perforated diverticulum---an extrarenal manifestation of ADPKD.

  1. Recurrent abscesses due to Finegoldia magna, Dermabacter hominis and Staphylococcus aureus in an immunocompetent patient.

    PubMed

    Martin, J; Bemer, P; Touchais, S; Asseray, N; Corvec, S

    2009-10-01

    A case of recurrent abscesses in an immunocompetent patient is reported, involving the opportunistic human pathogen Dermabacter hominis, the virulent anaerobic pathogen Finegoldia magna and Staphylococcus aureus. PMID:19332143

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

    PubMed

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

    1991-01-01

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

  3. Tree-in-bud pattern of chest CT images for diagnosis of Mycobacterium abscesses

    PubMed Central

    Chu, Haiqing; Li, Bing; Zhao, Lan; Huang, Dongdong; Xu, Jinfu; Zhang, Jingbo; Gui, Tao; Xu, Liyun; Luo, Liulin; Zhang, Zhemin; Sun, Xiwen

    2015-01-01

    Objectives: Changes of chest CT images in Mycobacterium and non-Mycobacterium abscesses in patients with lung disease were with a view to making an early diagnosis. Methods: 124 primary patients diagnosed with non-tuberculosis Mycobacterium infections with a positive sputum acid-fast smear were enrolled in this retrospective study. CT images and clinical data of these patients were analyzed. Results: The 52 Mycobacterium abscess lung disease cases included bronchiectasis 82.7% (43/52), which was more easily detected bilaterally than unilaterally (29/52 vs. 14/52), lung consolidation 44.2% (23/52), nodules 44.2% (22/52), cavities 32.7% (17/52), tree-in-bud pattern 42.3% (22/52) and patchy shadow 63.5% (33/52) in CT images. Tree-in-bud pattern was more common in Mycobacterium abscess compared with non-Mycobacterium abscess lung disease (42.3% vs. 18.1%, P = 0.004). A significant difference of the lung area involved by tree-in-bud in CT was found between non-Mycobacteria abscess and Mycobacterium abscess lung disease (17.0% vs. 7.2%, P < 0.001), and tree-in-bud occurred more readily unilaterally (21.2% vs. 6.9%, P = 0.029), and in the inferior lobe of the right lung (3.2% vs. 0.2%, P = 0.029) in Mycobacterium abscess lung disease. Patchy shadow was more common in non-Mycobacterium abscess lung disease (63.5% vs. 80.1%, P = 0.041). Further multi-factor analysis confirmed that tree-in-bud was an independent predictor of Mycobacterium abscess lung disease. Conclusions: Different CT results existed between non-Mycobacterium abscess and Mycobacterium abscess lung diseases. The tree-in-bud pattern might be helpful to choose a suitable therapy in patients, with an acid-fast bacilli smear-positive diagnosis of lung disease. PMID:26770485

  4. Intracranial abscesses: Retrospective analysis of 32 patients and review of literature

    PubMed Central

    Udoh, David O.; Ibadin, Emmanuel; Udoh, Mojisola O.

    2016-01-01

    Background: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not Objectives: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria. Materials and Methods: This is a retrospective analysis of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses between September 2006 and December 2011. Results: We carried out 40 procedures in 32 (23 male and 9 female) patients with various intracranial abscesses. These represented approximately 5.6% of all operative neurosurgical procedures in our unit since inception. Most abscesses [16, i.e. 50%] occurred in the second decade. In the first decade, there were 7 (22%), and after the age of 30 years, there were 4 (12.5%). The most susceptible single year of life was infancy with 4 (12.5%) cases of intracranial abscesses. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (9) or posttraumatic (6). Most abscesses (41%) were located in the frontal region, and intraparenchymal (i.e. intracerebral or intracerebellar) (50%) lesions were commoner than extradural, subdural, or intraventricular lesions. The commonest procedure performed (50%) was burr hole evacuation. Four patients (12.5% of cases) died. Prognosis appears to worsen with meningitis as the predisposing infection, ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion

  5. Intracranial abscesses: Retrospective analysis of 32 patients and review of literature

    PubMed Central

    Udoh, David O.; Ibadin, Emmanuel; Udoh, Mojisola O.

    2016-01-01

    Background: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not Objectives: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria. Materials and Methods: This is a retrospective analysis of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses between September 2006 and December 2011. Results: We carried out 40 procedures in 32 (23 male and 9 female) patients with various intracranial abscesses. These represented approximately 5.6% of all operative neurosurgical procedures in our unit since inception. Most abscesses [16, i.e. 50%] occurred in the second decade. In the first decade, there were 7 (22%), and after the age of 30 years, there were 4 (12.5%). The most susceptible single year of life was infancy with 4 (12.5%) cases of intracranial abscesses. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (9) or posttraumatic (6). Most abscesses (41%) were located in the frontal region, and intraparenchymal (i.e. intracerebral or intracerebellar) (50%) lesions were commoner than extradural, subdural, or intraventricular lesions. The commonest procedure performed (50%) was burr hole evacuation. Four patients (12.5% of cases) died. Prognosis appears to worsen with meningitis as the predisposing infection, ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion

  6. Disseminated Gonococcal Infection Presenting as Bacteremia and Liver Abscesses in a Healthy Adult

    PubMed Central

    Byun, Jongkyu; Yang, John Jeongseok

    2015-01-01

    Herein, we describe a bacteremia caused by Neisseria gonorrhoeae that presented as liver abscesses. The patient had no risk factors for disseminated gonococcal infection. Periodic fever, skin rashes, and papules were present and the results of an abdominal computed tomography scan indicated the presence of small liver abscesses. The results of blood culture and 16S rRNA sequencing of the bacterial isolates confirmed the presence of N. gonorrhoeae. The patient improved with antibiotic therapy. PMID:25844265

  7. Benign fibrous histiocytoma associated with a frontoethmoidal mucopyocele and orbital abscess.

    PubMed

    Kau, Hui-Chuan; Yang, Ching-Fen; Liu, I-Ting; Kao, Shu-Ching; Hsu, Wen-Ming; Teng, Michael Mu Huo; Tsai, Chieh-Chih

    2007-01-01

    A 74-year-old man sought treatment for painful swelling in the right upper eyelid. CT demonstrated a frontoethmoidal mucocele extending in the right orbit with abscess formation. Following functional endoscopic sinus surgery, the inflammatory symptoms in the right eye nearly resolved. However, a firm mass was still noted in the same location. Histopathologic examination proved it to be a benign fibrous histiocytoma. Benign fibrous histiocytoma may occur in association with an orbital abscess secondary to mucocele.

  8. Co-incidental diagnosis of an extradural abscess while siting an extradural catheter for postoperative analgesia.

    PubMed

    Mercer, M; McIndoe, A

    1998-06-01

    Extradural abscess is a rare but serious complication of the extradural route of administration of analgesic drugs. We report a case of spontaneous extradural abscess diagnosed during placement of an extradural catheter for analgesia after a negative diagnostic laparotomy. Magnetic resonance imaging is the usual diagnostic tool of choice. This, and subsequent surgery, confirmed the diagnosis suspected after drainage of pus through the Tuohy needle.

  9. Two cases of lateral sinus thrombosis presenting with extracranial head and neck abscesses.

    PubMed

    Pearson, C R; Riden, D K; Garth, R J; Thomas, M R

    1994-09-01

    Two cases of lateral sinus thrombosis in fit adults with no previous otological history are presented. One case occurred in association with Bezold's abscess and followed mastoiditis which was masked by previous antibiotic treatment. The other case occurred in association with an occipitoparietal scalp abscess and there was no obvious preceding middle ear infection. The causative bacteria were Streptococcus milleri and a variant Streptococcus intermedius. Lateral sinus thrombosis is discussed.

  10. Conservative management of delayed suprapubic abscess after laparoscopic Burch colposuspension using nonabsorbable polypropylene mesh.

    PubMed

    Balaloski, S P; Richards, S R; Singh, E

    1999-05-01

    To our knowledge, abscess formation after laparoscopic Burch colposuspension using permanent surgical mesh has not been previously reported. In our patient a suprapubic abscess was identified 4 weeks after the procedure in which polypropylene mesh was used. Conservative management involving drainage under computerized tomographic guidance and antibiotic therapy resulted in complete resolution without necessitating removal of the mesh. (J Am Assoc Gynecol Laparosc 6(2):225-228, 1999) PMID:10226139

  11. Co-incidental diagnosis of an extradural abscess while siting an extradural catheter for postoperative analgesia.

    PubMed

    Mercer, M; McIndoe, A

    1998-06-01

    Extradural abscess is a rare but serious complication of the extradural route of administration of analgesic drugs. We report a case of spontaneous extradural abscess diagnosed during placement of an extradural catheter for analgesia after a negative diagnostic laparotomy. Magnetic resonance imaging is the usual diagnostic tool of choice. This, and subsequent surgery, confirmed the diagnosis suspected after drainage of pus through the Tuohy needle. PMID:9771321

  12. Recurrent chest wall abscesses overlying a pneumonectomy scar: an unusual presentation of a cholecystocutaneous fistula.

    PubMed

    Hawari, Mohammad; Wemyss-Holden, Simon; Parry, Gareth Wyn

    2010-05-01

    We report a case of recurrent chest wall abscesses overlying a right thoracotomy scar four years after a pneumonectomy for a right middle lobe bronchus squamous cell carcinoma. Exploration of the abscess cavities revealed no intra-thoracic or intra-abdominal communication. The patient developed sinuses in his thoracotomy scar and two years later, two gallstones were expelled from these sinuses. A cholecystocutaneous fistula was confirmed on a fistulogram. PMID:20139203

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

    PubMed

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

    2012-10-01

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

  14. Localization of abscess in adult polycystic kidney by indium-111 leukocyte scan

    SciTech Connect

    Bretan, P.N. Jr.; Price, D.C.; McClure, R.D.

    1988-08-01

    In patients with adult polycystic kidney disease (APKD) infected cysts are difficult to localize with current radiographic techniques, especially those dependent on renal function. Indium-111 leukocyte (In-WBC) imaging is both highly sensitive and effective in detecting and localizing abscesses in patients with renal failure. We report on a patient with APKD and sepsis in whom computed tomography, ultrasound, and physical examination failed to locate the renal abscess, which was found by In-WBC scanning.

  15. Successful medical management of intra-abdominal abscesses in 4 adult horses

    PubMed Central

    Berlin, Dalia; Kelmer, Gal; Steinman, Amir; Sutton, Gail A.

    2013-01-01

    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

  16. Successful medical management of intra-abdominal abscesses in 4 adult horses.

    PubMed

    Berlin, Dalia; Kelmer, Gal; Steinman, Amir; Sutton, Gail A

    2013-02-01

    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.

  17. Abscess after a laparoscopic appendectomy presenting as low back pain in a professional athlete.

    PubMed

    Witkin, Lisa R; Nguyen, Hien T; Silberstein, Charles E; Fayad, Laura M; McFarland, Edward G

    2011-01-01

    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.

  18. Brodie's Abscess in a Patient Presenting with Sickle Cell Vasoocclusive Crisis.

    PubMed

    Ogbonna, Onyekachi Henry; Paul, Yonette; Nabhani, Hasan; Medina, Adriana

    2015-01-01

    First described by Sir Nicholas Brodie in 1832, Brodie's abscess is a localized subacute or chronic infection of the bone, typically seen in the metaphases of long bones in children and adolescents. The diagnosis can prove to be enigmatic due to absence of clinical signs and symptoms of systemic disease. We report a very interesting case of Brodie's abscess masquerading as sickle cell vasoocclusive crisis in a 20-year-old female with sickle cell disease and review the literature.

  19. Brodie's Abscess in a Patient Presenting with Sickle Cell Vasoocclusive Crisis

    PubMed Central

    Ogbonna, Onyekachi Henry; Paul, Yonette; Nabhani, Hasan; Medina, Adriana

    2015-01-01

    First described by Sir Nicholas Brodie in 1832, Brodie's abscess is a localized subacute or chronic infection of the bone, typically seen in the metaphases of long bones in children and adolescents. The diagnosis can prove to be enigmatic due to absence of clinical signs and symptoms of systemic disease. We report a very interesting case of Brodie's abscess masquerading as sickle cell vasoocclusive crisis in a 20-year-old female with sickle cell disease and review the literature. PMID:26290668

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

    PubMed

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

    1979-01-01

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

  1. Brodie's abscess of the distal radius: an unusual complication after percutaneous pinning.

    PubMed

    Johnson, Jeff W; Bindra, Randip R

    2008-12-01

    We report a case of Brodie's abscess of the distal radius that presented 4 years after closed reduction and percutaneous pinning for a closed distal radius fracture. This condition has not been previously reported in the adult distal radius and we detail the clinical features and imaging findings. We also present a new way of management of Brodie's abscess using injectable bone substitute along with adjunctive parenteral antibiotic therapy.

  2. Brodie’s Abscess of the Distal Radius: An Unusual Complication after Percutaneous Pinning

    PubMed Central

    Bindra, Randip R.

    2008-01-01

    We report a case of Brodie’s abscess of the distal radius that presented 4 years after closed reduction and percutaneous pinning for a closed distal radius fracture. This condition has not been previously reported in the adult distal radius and we detail the clinical features and imaging findings. We also present a new way of management of Brodie’s abscess using injectable bone substitute along with adjunctive parenteral antibiotic therapy. PMID:18780011

  3. A Rare Case of Toxic Myocarditis Caused by Bacterial Liver Abscess Mimicking Acute Myocardial Infarction

    PubMed Central

    Zou, Yuhai; Lin, Lin; Xiao, Hua; Xiang, Dingcheng

    2016-01-01

    Patient: Male, 66 Final Diagnosis: Toxic myocarditis Symptoms: — Medication: — Clinical Procedure: Emergency Specialty: Cardiology Objective: Rare disease Background: Chills, high fever, right upper abdomen pain, and increased white blood cell count are the main and common clinical features of bacterial liver abscess. It is rare to see bacterial liver abscess present symptoms of myocardial injury first, and this can lead to misdiagnosis. Case Report: We report a case of toxic myocarditis caused by bacterial liver abscess. The patient first presented with chest pain, ST segment elevation, and elevated TNI, which misled us to diagnose myocardial infarction, but the coronary artery had no stenosis or obstructive lesions after emergency coronary angiography. Then we modified the diagnosis to toxic myocarditis. Bacterial liver abscess was the proposed etiology after a series of auxiliary examinations. Finally, antibiotics and percutaneous liver puncture catheter drainage were used to improve the clinical outcome. Conclusions: It is rare that patients with bacterial liver abscess first present symptoms of myocardial injury. Differential diagnosis between myocarditis and myocardial infarction should be careful, as myocarditis is a diagnosis of exclusion, and coronary angiography is necessary to confirm coronary disease. Percutaneous liver puncture catheter drainage can effectively cure bacterial liver abscess. PMID:26726772

  4. Community-Acquired Methicillin-Resistant Pyogenic Liver Abscess: A Case Report.

    PubMed

    Cherian, Joel; Singh, Rahul; Varma, Muralidhar; Vidyasagar, Sudha; Mukhopadhyay, Chiranjay

    2016-01-01

    Pyogenic liver abscesses are rare with an incidence of 0.5% to 0.8% and are mostly due to hepatobiliary causes (40% to 60%). Most are polymicrobial with less than 10% being caused by Staphylococcus aureus. Of these, few are caused by methicillin-resistant Staphylococcus aureus (MRSA) and fewer still by a community-acquired strain. Here we present a case study of a patient with a community-acquired MRSA liver abscess. The patient presented with fever since 1 month and tender hepatomegaly. Blood tests revealed elevated levels of alkaline phosphatase, C-reactive protein, erythrocyte sedimentation rate, and neutrophilic leukocytosis. Blood cultures were sterile. Ultrasound of the abdomen showed multiple abscesses, from which pus was drained and MRSA isolated. Computed tomography of the abdomen did not show any source of infection, and an amebic serology was negative. The patient was started on vancomycin for 2 weeks, following which he became afebrile and was discharged on oral linezolid for 4 more weeks. Normally a liver abscess is treated empirically with ceftriaxone for pyogenic liver abscess and metronidazole for amebic liver abscess. However, if the patient has risk factors for a Staphylococcal infection, it is imperative that antibiotics covering gram-positive organisms be added while waiting for culture reports. PMID:27540556

  5. CALCIFICATION OF THE BREAST FOLLOWING A TYPHOID ABSCESS.

    PubMed

    Thayer, W S; Hazen, H H

    1907-01-23

    1. In a patient with typhoid fever, who had taken, during eleven days, 132 grammes of lactate of calcium by the mouth, as well as 5 grammes of chloride of calcium subcutaneously, there developed, eleven days after the subcutaneous infusion, a large abscess of the breast from which Bacillus typhosus and Staphylococcus aureus were obtained on culture. The abscess was opened and the wound packed with iodoform gauze. Eleven days later a deposit of calcium appeared in the granulation tissue bordering the wound. This rapidly increased until the rim of the opening and the lining granulation tissue were converted into a hard, calcareous mass. A number of nodules of an apparently similar character appeared in other parts of the breast. 2. A month later the iodoform packing was removed and the patient was put on a carbohydrate free diet. This was continued for twenty-four of the next thirty-six days. Under this treatment the abscess almost entirely healed with complete disappearance of the deposit of calcium. 3. Studies of the intake and output of calcium showed that, during three days under a diet of milk and eggs there was a material calcium retention ((I).346 grammes) : (b) That during two periods amounting to three weeks in all, under a carbohydrate free diet, there was an excess of Ca elimination over the intake of 3.672 grammes, (c) That during ten days following the last carbohydrate free period, under a normal diet, there was a retention of calcium amounting to 0.602 gramme. 4. The disappearance of calcium from the breast was associated in time with the carbohydrate free diet and the excessive elimination of calcium. 3. Under the carbohydrate free diet acetone and diacetic acid appeared on two occasions in the urine, but were not accompanied by any increase in the elimination of calcium. 6. With regard to the cause of the calcification, we cannot speak with certainty. The remarkable association of the deposition of calcium at the seat of an injection of calcium

  6. Amebic liver abscess: epidemiology, clinical features, and outcome.

    PubMed Central

    Seeto, R K; Rockey, D C

    1999-01-01

    Amebic liver abscess (ALA) is a serious, but readily treatable form of hepatic infection. In order to understand the clinical features of this condition in the United States, we reviewed the medical histories of 56 patients with ALA at two large San Francisco Hospitals from 1979 to 1994. Patients were divided into the following groups based on the presumed manner in which they had acquired ALA: those born or raised in the United States, with a history of travel to an endemic area (Tr-ALA); those from an endemic area, but living in the United States for less than one year (En-ALA); and those neither from nor having traveled to an endemic area (N-ALA). We found distinct clinical patterns in patients from different epidemiological groups. Patients with Tr-ALA were a decade older than those from endemic regions, were more likely to be male, and tended to have an insidious onset. Furthermore, compared to patients with En-ALA, those with Tr-ALA were more likely to have hepatomegaly (P < 0.0001) and large abscesses (ALA > 10 cm; P < 0.01). One third of the patients studied had no associated travel history or endemic origin as risk factors. Of these, 63% had a condition consistent with severe immunosuppression, such as infection with the human immunodeficiency virus (HIV), malnourishment with severe hypoalbuminemia, or chronic infection. In patients with N-ALA, the presence of a presumed immunosuppressed state increased significantly, as compared to patients with endemic or travel risk factors for ALA. During the last five years of the study, one third of all patients diagnosed with ALA were HIV positive (including 2 with a new diagnosis of AIDS), many of whom were discovered to be HIV-infected only after presentation with ALA. We conclude that travel to and origin in an endemic area are important risk factors for the development of ALA, and patients in these different epidemiological groups appear to have distinct clinical features. Further, in the absence of recognized

  7. Novel use of a radiolabelled antibody against stage specific embryonic antigen for the detection of occult abscesses in mammals

    DOEpatents

    Thakur, Madhukar L.

    1990-01-01

    The invention discloses improved reagents containing antibodies against stage specific embryonic antigen-1 antibodies and improved methods for detection of occult abscess and inflammation using the improved reagents.

  8. Pleuritis secondary to pneumonia or lung abscessation in 90 horses.

    PubMed

    Raphel, C F; Beech, J

    1982-10-15

    Of 122 horses with pleural effusion, 90 (73.8%) had pleuritis secondary to pneumonia or lung abscessation. Fifty-one horses died or were euthanatized. The highest prevalence was in Thoroughbred and Standardbred racehorses. Eleven (12.2%) horses were postsurgical patients and 22 (24.4%) horses had been transported over 500 miles. There was no relationship between final outcome and the age, sex, breed, hematologic values, or laboratory findings pertaining to pleural fluid except for the bacterial isolation of Escherichia coli from the pleural fluid, as this was more frequently associated with death. Follow-up on 38 of the 39 horses that survived showed that 18 (46.2%) recovered and were able to return to performance equal to that prior to their illness. Ten (25.6%) were returned for breeding or pleasure use, with no attempt made to return them to racing. Follow-up was not available for 5 horses, 4 horses had just recently been discharged from the hospital, and 2 horses are racing poorer than prior to their illness. PMID:7141978

  9. Large retropharyngeal abscess: a case of mistaken identity.

    PubMed

    Makaram, N; Gohil, R; Gardiner, Q; Manickavasagam, J

    2016-01-01

    We report an unusual case of nasopharyngeal carcinoma (NPC), presenting initially as a retropharyngeal collection. We discuss the investigation, diagnosis and management of NPC and furthermore review the literature of NPC, emphasising the varied presentation. A 44-year-old Caucasian male ex-smoker presented with a 10-day history of a painless left-sided neck lump; progressive dysphagia and unintentional weight loss. Examination demonstrated a large left posterior pharyngeal swelling with soft palatal effacement, confirmed on nasoendoscopy. A CT scan revealed a fluid collection in the retropharyngeal space, which partially occluded the nasopharynx, and numerous satellite lesions were identified along with cervical lymphadenopathy. The suspected abscess was drained in theatre and nasopharyngeal biopsies were taken. These revealed Epstein-Barr virus-positive NPC. Staging investigations revealed a T4N2M0l carcinoma. Treatment consisted of radical chemoradiation therapy with curative intent. NPC is known for its varied and late presentation, and is an important condition to be aware of when considering a differential diagnosis of pharyngeal masses. PMID:27637277

  10. Large retropharyngeal abscess: a case of mistaken identity.

    PubMed

    Makaram, N; Gohil, R; Gardiner, Q; Manickavasagam, J

    2016-01-01

    We report an unusual case of nasopharyngeal carcinoma (NPC), presenting initially as a retropharyngeal collection. We discuss the investigation, diagnosis and management of NPC and furthermore review the literature of NPC, emphasising the varied presentation. A 44-year-old Caucasian male ex-smoker presented with a 10-day history of a painless left-sided neck lump; progressive dysphagia and unintentional weight loss. Examination demonstrated a large left posterior pharyngeal swelling with soft palatal effacement, confirmed on nasoendoscopy. A CT scan revealed a fluid collection in the retropharyngeal space, which partially occluded the nasopharynx, and numerous satellite lesions were identified along with cervical lymphadenopathy. The suspected abscess was drained in theatre and nasopharyngeal biopsies were taken. These revealed Epstein-Barr virus-positive NPC. Staging investigations revealed a T4N2M0l carcinoma. Treatment consisted of radical chemoradiation therapy with curative intent. NPC is known for its varied and late presentation, and is an important condition to be aware of when considering a differential diagnosis of pharyngeal masses.

  11. [Henoch-Schönlein Purpura with lung abscess].

    PubMed

    Nakazawa, Junji; Watanabe, Atsushi; Nakajima, Tomohiro; Mishina, Taijiro; Miyajima, Masahiro; Higami, Tetsuya

    2013-09-01

    A 72-year-old man had underwent left lower lobectomy for squamous cell carcinoma in our hospital in 2008. Postoperative stage was I A (T1N0M0). In 2010, follow-up chest computed tomography (CT) images showed similar cavitary nodules in segments 2 and 8 of the right lung with positive uptake on fluorodeoxyglucose-positron emission tomography (FDG-PET) images. Physical examination, blood tests, and levels of serum tumor markers showed no abnormality. Transbronchial lung biopsy revealed the absence of malignant cells. Segment 8 of the right lower lobe with the nodule was partially resected, and pathological examination demonstrated lung abscess. He was discharged but was hospitalized in another hospital for purpuric rash, fever, and arthralgia. Microscopic albuminuria was noted, and renal biopsy revealed nephritis with immunoglobulin A( IgA)deposition. He was made a diagnosis of Henoch-Schönlein purpura. Oral steroid therapy( prednisolone 60 mg/d) was initiated, resulting in the improvement of symptoms and disapearance of the cavitary nodule in the right lung segment 2. PMID:24008637

  12. Bacterial flora of liver abscesses in feedlot cattle fed tylosin or no tylosin.

    PubMed

    Nagaraja, T G; Beharka, A B; Chengappa, M M; Carroll, L H; Raun, A P; Laudert, S B; Parrott, J C

    1999-04-01

    Bacterial flora of liver abscesses from cattle fed tylosin or no tylosin and susceptibilities of the predominant bacterial isolates to tylosin and other antimicrobial compounds were determined. Abscessed livers were collected at slaughter from cattle originating from feedlots that had fed tylosin (n = 36) or no tylosin (n = 41) for at least 2 yr, and segments of livers with one or two intact abscesses were transported to the laboratory. Abscesses were cultured for anaerobic and facultative bacteria. Fusobacterium necrophorum, either as single culture or mixed with other bacteria, was isolated from all abscesses. The incidence of subsp. necrophorum, as part of the mixed infection, was lower (P < .05) in the tylosin group than in the no-tylosin group (33 vs 61%). However, the incidence of Actinomyces pyogenes was higher (P < .01) in the tylosin group than in the no-tylosin group (53 vs 10%). Totals of 119 F. necrophorum and 21 A. pyogenes isolates were used for determinations of susceptibilities to bacitracin, oxytetracycline, chlortetracycline, lasalocid, monensin, tylosin, tilmicosin, and virginiamycin. The minimum inhibitory concentrations (MIC) of antibiotics were determined with a broth microdilution method. The mean MIC of tylosin for F. necrophorum and A. pyogenes were not different between isolates from tylosin and no-tylosin groups. We concluded that continuous feeding of tylosin did not induce resistance in F. necrophorum or A. pyogenes. Also, the higher incidence of mixed infection of F. necrophorum and A. pyogenes in liver abscesses of tylosin-fed cattle suggests a potential synergistic interaction between the two organisms in causing liver abscesses. PMID:10328365

  13. Prostatic abscess: Objective assessment of the treatment approach in the absence of guidelines

    PubMed Central

    Elshal, Ahmed M.; Abdelhalim, Ahmed; Barakat, Tamer S.; Shaaban, Atallah A.; Nabeeh, Adel; Ibrahiem, El-Housseiny

    2014-01-01

    Objective To assess the outcome of the drainage procedure used for treating a prostatic abscess, and to propose a treatment algorithm to reduce the morbidity and the need for re-treatment. Patients and methods We retrospectively reviewed patients who were admitted and received an interventional treatment for a prostatic abscess. All baseline relevant variables were reviewed. Details of the intervention, laboratory data, duration of hospital stay, follow-up data and re-admissions were recorded. Results A prostatic abscess was diagnosed in 42 patients; 30 were treated by transurethral deroofing and 12 by transrectal needle aspiration. The median (range) size of the abscess was 4.5 (2–23) mL and 2.7 (1.5–7.1) mL in the deroofing and aspiration groups, respectively (P = 0.2). In half of the cases multiple abscesses were evident on imaging before the intervention. The median (range) hospital stay after deroofing and aspiration was 2 (1–11) and 1 (1–19) days, respectively (P = 0.04). Perioperative complications occurred only in the deroofing group, in which two patients developed septic shock requiring intensive care (Clavien 4) and one developed epididymo-orchitis (Clavien 2). There were two late complications in the deroofing group, in which one patient developed a urethral stricture that required endoscopic urethrotomy (Clavien 3a) and one developed a urethral diverticulum and urinary incontinence that required diverticulectomy and a bulbo-urethral sling procedure (Clavien 3b). A urethro-rectal fistula developed after aspiration in one patient. Re-treatment for the abscess was indicated in two (7%) patients in the deroofing group, which was treated by aspiration. Conclusion Transrectal needle aspiration for a prostatic abscess, when done for properly selected cases, could minimise the morbidity of the drainage procedure. PMID:26019960

  14. Nomogram Estimating the Probability of Intraabdominal Abscesses after Gastrectomy in Patients with Gastric Cancer

    PubMed Central

    Eom, Bang Wool; Joo, Jungnam; Park, Boram; Yoon, Hong Man; Ryu, Keun Won; Kim, Soo Jin

    2015-01-01

    Purpose Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period. Materials and Methods We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets. Results The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess. Conclusions This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge. PMID:26816657

  15. Structural characteristics of polysaccharides that induce protection against intra-abdominal abscess formation.

    PubMed Central

    Tzianabos, A O; Onderdonk, A B; Zaleznik, D F; Smith, R S; Kasper, D L

    1994-01-01

    Bacteroides fragilis is the anaerobe most commonly isolated from clinical cases of intra-abdominal sepsis. In a rodent model of this disease process, intraperitoneal injection of the capsular polysaccharide complex (CPC) from B. fragilis provokes abscess formation, while subcutaneous administration of this complex confers protection against B. fragilis-induced intra-abdominal abscesses. The CPC consists of two discrete polysaccharides, polysaccharides A and B (PS A and PS B), each possessing oppositely charged structural groups critical to the ability of these carbohydrates to induce the formation of abscesses. Other bacterial polysaccharides that possess oppositely charged groups (such as the group antigen or capsular polysaccharide from Streptococcus pneumoniae type 1 strains) also exhibited potent abscess-inducing capabilities. We report here that positively and negatively charged groups on polysaccharides are also essential for inducing protection against abscess formation. Vaccination of rats with B. fragilis PS A, PS B, or the S. pneumoniae type 1 capsule protected against intra-abdominal abscesses subsequent to intraperitoneal challenge with each of these polysaccharides. Chemical conversion of the free amino or carboxyl groups on PS A to uncharged N-acetyl or hydroxymethyl groups, respectively, abrogated the ability of this polymer to confer protection against polysaccharide-mediated abscess formation. Adoptive transfer of splenic T cells from polysaccharide-vaccinated rats to naive animals demonstrated that T cells mediated this protective activity. T cells transferred from animals vaccinated with a polysaccharide repeating unit (Salmonella typhi Vi antigen) that normally contains one carboxyl group but was chemically converted to a polymer that possesses both free amino and carboxyl groups (accomplished by de-N-acetylating the Vi antigen) protected naive T-cell recipients against polysaccharide-induced abscesses. These results demonstrate that a distinct

  16. Staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess.

    PubMed

    Zeng, Hao; Zhang, Yupeng; Shen, Xiongjie; Luo, Chengke; Xu, Zhengquan; Liu, Zheng; Liu, Xiangyang; Wang, Xiyang

    2015-01-01

    The study was to investigate the feasibility and effectiveness of posterior-only approach combining with puncture drainage under CT-guide in staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess. We retrospectively analyzed 15 patients (came from 72 cases with thoracic and lumbar spinal tuberculosis) with flow injection abscesses underwent surgery from January 2007 to February 2009, and evaluated the American Spinal Injury Association (ASIA) scoring system of nerve function, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), abscess absorption time and the Oswestry Disability Index (ODI), preoperatively and postoperatively. 15 patients were followed up for 13-37 months, no recurrence of tuberculosis, no fixation loosening and neurologic symptoms aggravated. The flow injection abscesses are absorbed within 3-6 months postoperative operation. In final follow-up, ESR went down to 5.2±2.1 mm/h from preoperative 79.6±14.8 mm/h, CRP decreased from preoperative 49.3±7.5 mg/L to 1.8±0.7 mg/L, ODI changed from 75.13±20.15 to 16.72±8.62, all of them changed significantly (P<0.05). In conclusions, one-stage posterior debridement, interbody fusion, pedicle screw fixation and two-stage CT-guided interventional therapy were safe and effective in treatment of the thoracic and lumbar spinal tuberculosis with flow injection abscess. PMID:26770442

  17. Abscess in Adenomyosis Mimicking a Malignancy in a 54-Year-Old Woman

    PubMed Central

    Meydanli, Mehmet M.; Alkan, Alpay; Edali, Mehmet N.; Gokce, Hasan; Kafkasli, Ayşe

    2003-01-01

    Background: Although there are a few reports describing abscess formation in endometriotic foci no report of abscess formation arising de novo within adenomyosis appears in the literature. Preoperative diagnosis of adenomyosis is frequently difficult because of non-specific signs and symptoms. Synchronous pelvic pathologies such as leiomyoma, endometrial polyp, endometrial hyperplasia, as well as endometrial cancer may cause differential diagnostic problems. Case: A 54-year-old postmenopausal woman complaining of inguinal pain, nightsweats and hot flashes is presented. Radiologic examinations of the pelvis revealed a 95 × 85 mm leiomyoma-like lesion including a 53 × 43 mmcystic space and 9 × 6 mmpapillary formation within the uterus raising clinical suspicion of malignancy. A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed accompanied by a frozen section diagnosis. The frozen section revealed an abscess formation arising in a focus of adenomyosis. The postoperative period of the patient was uneventful. Conclusion : The present case, to our knowledge, is the first report representing abscess formation in adenomyosis. Abscess arising within adenomyosis can strongly raise the suspicion of endometrial cancer, particularly if the patient is postmenopausal. If endometrial cancer cannot be ruled out with definitive histopathological diagnosis in the preoperative period, a frozen section becomes mandatory during surgical intervention. PMID:12839634

  18. Retroperitoneal metastatic germ cell tumor presenting as a psoas abscess: a diagnostic pitfall.

    PubMed

    Dieker, Carrie A; De Las Casas, Luis E; Davis, Brian R

    2013-07-01

    Most testicular neoplasms are germ cell tumors, the vast majority of which represent seminomas. Most seminomas present localized to the testis, whereas nonseminomatous germ cell tumors more often present with lymph node metastases. Psoas abscesses generally arise from a contiguous intra-abdominal or pelvic infectious process, an adjacent focus of osteomyelitis or septic emboli from distant infectious foci. In this study, the case of a 24-year-old man who presented with a right psoas mass presumptively diagnosed as an abscess secondary to fever and leukocytosis is presented. The patient had a history of right testicular seminoma, and normal serum levels of alpha-fetoprotein and human chorionic gonadotropin. Surgical exploration and biopsy demonstrated seminoma metastasis. This case represents an extremely unusual clinical presentation of metastatic germ cell tumor presenting as a psoas abscess. This unique case represents an unusual presentation of a recurrent germ cell tumor mimicking a psoas abscess. Awareness of possible metastatic testicular germ cell neoplasm as a psoas abscess could prevent diagnosis delay before retroperitoneal tumor debulking. PMID:23360792

  19. Staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess

    PubMed Central

    Zeng, Hao; Zhang, Yupeng; Shen, Xiongjie; Luo, Chengke; Xu, Zhengquan; Liu, Zheng; Liu, Xiangyang; Wang, Xiyang

    2015-01-01

    The study was to investigate the feasibility and effectiveness of posterior-only approach combining with puncture drainage under CT-guide in staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess. We retrospectively analyzed 15 patients (came from 72 cases with thoracic and lumbar spinal tuberculosis) with flow injection abscesses underwent surgery from January 2007 to February 2009, and evaluated the American Spinal Injury Association (ASIA) scoring system of nerve function, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), abscess absorption time and the Oswestry Disability Index (ODI), preoperatively and postoperatively. 15 patients were followed up for 13-37 months, no recurrence of tuberculosis, no fixation loosening and neurologic symptoms aggravated. The flow injection abscesses are absorbed within 3-6 months postoperative operation. In final follow-up, ESR went down to 5.2±2.1 mm/h from preoperative 79.6±14.8 mm/h, CRP decreased from preoperative 49.3±7.5 mg/L to 1.8±0.7 mg/L, ODI changed from 75.13±20.15 to 16.72±8.62, all of them changed significantly (P<0.05). In conclusions, one-stage posterior debridement, interbody fusion, pedicle screw fixation and two-stage CT-guided interventional therapy were safe and effective in treatment of the thoracic and lumbar spinal tuberculosis with flow injection abscess. PMID:26770442

  20. Tuberculosis simulating brain tumour.

    PubMed

    Chaudhry, U R; Farooq, M; Rauf, F; Bhatti, S K

    2011-06-30

    The purpose of the study is to highlight the varied presentation of tuberculosis (TB) simulating a brain tumour. Headache and seizures are becoming frequent presenting complaints without any history of tuberculosis. The study comprises 1200 patients of both sexes with ages ranging from ten to sixty years. CT scan and MRI brain control with and without contrast medium were the investigations performed in these cases. In some patients Electroencephalography (EEG), cerebral angiography (DSA) and spectroscopy were also performed. The final diagnosis of tuberculosis was made on the basis of craniotomy, stereotactic and burr hole biopsies with histopathology in most of the cases. Forty per cent of the patients were followed up for eight months. They were put on anti-tuberculosis treatment with symptomatic and anti-epileptic drugs. The incidence was 544 and 757 per 100,000 in Africa and Indo Pakistan respectively. The male to female ratio was 1:1. Tuberculosis, especially with CNS involvement, is not only common in immunosuppressed patients in our setting, but TB has been and remains an important public health problem. TB may involve the CNS either as meningitis or as parenchymal granulomas or abscesses. Patients with brain TB usually present with fever, multiple cranial nerve involvement and occasional behavioural changes. CSF findings remain non specific in most cases. The most common sites are the cerebral hemisphere and basal ganglion in adults and the cerebellum in children. Tuberculosis has unique findings on brain CT and MRI. Cortical and subcortical locations are typical whereas the brain stem is a less common site. Tuberculosis lesions are usually solitary but multiple in 10% to 35% of cases. In spite of all these facts some cases of brain TB still need aggressive neurointervention to reach the final diagnosis of brain TB. Tuberculosis in the CNS may manifest in many different ways. So one should always include tuberculosis in the differential diagnosis in the

  1. Intramuscular Injection Abscess Due to VRSA: A New Health Care Challenge.

    PubMed

    Sambandam, Senthil Nathan; Rohinikumar, Ganeshkumar Jayasree; Gul, Arif; Mounasamy, Varatharaj

    2016-06-01

    Abscess formation following intramuscular injections is rare and they are most commonly seen in immunocompromised individuals. In this case series we present a cohort of three patients presented to us in a critically ill condition with an abscess due to intramuscular injection. Vancomycin resistant staphylococcus aureus was isolated from all three patients. These patients posed a major challenge to the healthcare system and the treating physician because of the: severity of illness, virulence and resistance of the organism, rarity of the situation, immune state of the patient, and lack of supporting evidence to properly guide management in the use of health resources. To the best of our knowledge, there is no report available in the English literature on vancomycin resistant staphylococcus aureus associated with intramuscular injection abscess. PMID:27517077

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

    PubMed

    Nespola, Benoît; Betz, Valérie; Brunet, Julie; Gagnard, Jean-Charles; Krummel, Yves; Hansmann, Yves; Hannedouche, Thierry; Christmann, Daniel; Pfaff, Alexander W; Filisetti, Denis; Pesson, Bernard; Abou-Bacar, Ahmed; Candolfi, Ermanno

    2015-01-01

    A 72-year-old man consulted in November 2012 for abdominal pain in the right upper quadrant. The patient had a history of suspected hepatic amebiasis treated in Senegal in 1985 and has not traveled to endemic areas since 1990. Abdominal CT scan revealed a liver abscess. At first, no parasitological tests were performed and the patient was treated with broad-spectrum antibiotics. Only after failure of this therapy, serology and PCR performed after liver abscess puncture established the diagnosis of hepatic amebiasis. The patient was treated with metronidazole and tiliquinol-tilbroquinol. Amebic liver abscess is the most frequent extra-intestinal manifestation. Hepatic amebiasis 22 years after the last visit to an endemic area is exceptional and raises questions on the mechanisms of latency and recurrence of these intestinal protozoan parasites. PMID:26088504

  3. Cervical Epidural Abscess in Haemodialysis Patients by Catheter Related Infection: Report of Two Cases

    PubMed Central

    Gezici, Ali Riza

    2010-01-01

    Despite advances in neuroimaging and neurosurgical treatment modalities, spinal epidural abscess remains a challenging problem. Early diagnosis is often difficult and treatment is always delayed. Spinal epidural abscess usually develops in patients with predisposing factors such as IV drug abuse, senillity, diabetes mellitus, spinal attempts, alcoholism, immunosuppression, liver diseases and catheterizations. It is rarely seen in cervical region. A successful treatment is only possible with early diagnosis and accurate surgical and medical treatment. Optimal management is unclear and morbidity and mortality are significant. We present two adult haemodialysis patients with end-stage renal insufficiency who developed cervical epidural abscess following central venous catheter placement. Early surgical intervention is mandatory in cases those have progressive neurological deficit and spinal deformity, and this is also increases the success rate of medical therapy. PMID:20052368

  4. Comparison of In-111-MERC leukocytes with In-111-Oxine leukocytes for abscess detection

    SciTech Connect

    Intenzo, C.M.; Desai, A.G.; Thakur, M.L.; Park, C.H.

    1985-05-01

    This study was done to compare the clinical results of generally accepted Indium-111-oxine (oxine) labeled leukocytes with a relatively newer Indium-111-2-Mercaptopyridine-N-oxide (Merc) labeled leukocytes for the detection of occult abscesses. Of the 74 patients suspected of harboring an occult abscess, autologous leukocytes of 34 patients were labeled with oxine while in 40 patients Merc labeled leukocytes were used. Whole body imaging was performed at 24 hours. Interpretation of the scans was done without the knowledge of the leukocyte label (i.e. oxine vs Merc). The diagnosis was confirmed in each case by either subsequent clinical course, radiographic correlation (CT, US, etc.), surgery pathology, or autopsy. The results presented in this paper indicate that there is no significant difference between the Merc and oxine labeled leukocytes for abscess detection. The ease of labeling and potential availability of Merc as a kit is an advantage.

  5. Intramuscular Injection Abscess Due to VRSA: A New Health Care Challenge

    PubMed Central

    Sambandam, Senthil Nathan; Rohinikumar, Ganeshkumar Jayasree; Gul, Arif; Mounasamy, Varatharaj

    2016-01-01

    Abscess formation following intramuscular injections is rare and they are most commonly seen in immunocompromised individuals. In this case series we present a cohort of three patients presented to us in a critically ill condition with an abscess due to intramuscular injection. Vancomycin resistant staphylococcus aureus was isolated from all three patients. These patients posed a major challenge to the healthcare system and the treating physician because of the: severity of illness, virulence and resistance of the organism, rarity of the situation, immune state of the patient, and lack of supporting evidence to properly guide management in the use of health resources. To the best of our knowledge, there is no report available in the English literature on vancomycin resistant staphylococcus aureus associated with intramuscular injection abscess. PMID:27517077

  6. An unusual complication of epistaxis: cerebral abscess formation after anterior ethmoidal artery ligation.

    PubMed

    Murer, Karin; Holzmann, David; Burkhardt, Jan-Karl; Soyka, Michael Benjamin

    2015-12-29

    Epistaxis is a very common emergency in otorhinolaryngology. Anterior ethmoidal artery ligation using an external approach is one of the surgical options in posterior epistaxis. We present, to the best of our knowledge, the first reported case of an intracerebral abscess after epistaxis treatment with ligation of the anterior ethmoidal artery using an endoscopic-assisted external approach in a 56-year-old patient. The patient presented 4 days postoperatively with an orbital cellulitis. A CT was performed and a frontobasal hypodensity was found. An additional MR tomography the next day showed a lesion suspicious for an intracerebral abscess. Despite intravenous antibiotic therapy, the lesion increased and was successfully treated by the neurosurgeons, with abscess resection over a craniotomy and frontobasal repair using a pedicled periosteal flap. Surgeons have to be aware of this rare but possibly lethal severe complication and should consider early imaging studies, especially if a periorbital cellulitis appears.

  7. Amebic liver abscess and human immunodeficiency virus infection: a report of three cases.

    PubMed

    Liu, C J; Hung, C C; Chen, M Y; Lai, Y P; Chen, P J; Huang, S H; Chen, D S

    2001-07-01

    Invasive amebiasis rarely occurs in homosexual men and human immunodeficiency virus (HIV)-infected individuals and has not been regarded as a beacon for concomitant HIV infection. We encountered a bisexual man with a protracted course of amebic liver abscess and amebic colitis. In the presence of fever, generalized lymphadenopathy, and elevated serum aminotransferase levels, HIV infection was suspected and then confirmed by a de novo seroconversion of HIV antibody. Subsequently, we noted two consecutive patients with amebic liver abscess, also later found to be infected with HIV. The ameba obtained from these three cases was identified as Entamoeba histolytica by amplification of 16S ribosomal RNA by polymerase chain reaction and direct sequencing. This observation suggests that amebic liver abscess and colitis can be presentations for HIV infection in the Far East. Thus, the local patients with invasive amebiasis, especially those with a protracted course or with risk factors of HIV infection, should be tested for HIV.

  8. Adrenal abscess in a 3-week-old neonate – a case report

    PubMed Central

    Witkowska-Sędek, Ewelina; Warchoł, Stanisław; Dudek-Warchoł, Teresa; Brzewski, Michał; Pyrżak, Beata

    2015-01-01

    The authors present a case of a 6-year-old boy operated on in the 4th week of life because of adrenal abscess. The diagnosis of an adrenal abscess in the neonatal period is challenging due to its rare occurrence and non-specific signs. Adrenal abscesses can develop via two mechanisms: as a result of a hematogenic infection and a spread of bacteria to “normal” adrenal glands or, which is much more common, a complication of an adrenal hematoma. Early and accurate diagnosis is crucial for appropriate therapeutic management. Imaging, including ultrasound, can be problematic. The final diagnosis is frequently established on the basis of a histological examination of a surgical specimen. PMID:26807300

  9. A Very Rare Cause of a Relapsing Para-Oesophageal Abscess

    PubMed Central

    Wespi, Simon Peter; Frei, Remus; Sulz, Michael Christian

    2016-01-01

    Oesophageal involvement in Crohn's disease (CD) is uncommon and most often accompanied by involvement of more distal parts. Its presentation is mostly non-specific, and therefore a diagnosis, especially in isolated oesophageal disease, is difficult. We present the case of a 42-year-old male patient who was referred to our gastroenterology department because of a para-oesophageal abscess. Under antibiotic treatment the abscess healed, but despite great diagnostic efforts, its aetiology remained unclear. Three years later the patient was hospitalized again because of an abscess at the same site. Endoscopy showed disseminated ulcerations of the lower oesophagus, raising suspicion of CD. After excluding other possible causes, we made the diagnosis of isolated CD of the oesophagus. We review the available literature on this topic and discuss the clinical presentation, symptoms, endoscopic findings, and histology as well as treatment of oesophageal CD. PMID:27403115

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

    PubMed

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

    2013-04-01

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

  11. Genome Sequences of Salmonella enterica subsp. enterica Serovar Lubbock Strains Isolated from Liver Abscesses of Feedlot Cattle

    PubMed Central

    Amachawadi, Raghavendra G.; Thomas, Milton

    2016-01-01

    The genome sequencing of 13 Salmonella enterica subsp. enterica serovar Lubbock strains isolated from liver abscesses of feedlot cattle is reported here. The availability of these genomes will help to further understand the etiologic role of Salmonella strains in liver abscesses of cattle and will serve as references in microbial trace-back studies to improve food safety. PMID:27151794

  12. Percutaneous Transhepatic Drainage of Inaccessible Abdominal Abscesses Following Abdominal Surgery Under Real-Time CT-Fluoroscopic Guidance

    SciTech Connect

    Yamakado, Koichiro Takaki, Haruyuki; Nakatsuka, Atsuhiro; Kashima, Masataka; Uraki, Junji; Yamanaka, Takashi; Takeda, Kan

    2010-02-15

    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.

  13. Citrobacter freundii invades and replicates in human brain microvascular endothelial cells.

    PubMed

    Badger, J L; Stins, M F; Kim, K S

    1999-08-01

    Neonatal bacterial meningitis remains a disease with unacceptable rates of morbidity and mortality despite the availability of effective antimicrobial therapy. Citrobacter spp. cause neonatal meningitis but are unique in their frequent association with brain abscess formation. The pathogenesis of Citrobacter spp. causing meningitis and brain abscess is not well characterized; however, as with other meningitis-causing bacteria (e.g., Escherichia coli K1 and group B streptococci), penetration of the blood-brain barrier must occur. In an effort to understand the pathogenesis of Citrobacter spp. causing meningitis, we have used the in vitro blood-brain barrier model of human brain microvascular endothelial cells (HBMEC) to study the interaction between C. freundii and HBMEC. In this study, we show that C. freundii is capable of invading and trancytosing HBMEC in vitro. Invasion of HBMEC by C. freundii was determined to be dependent on microfilaments, microtubules, endosome acidification, and de novo protein synthesis. Immunofluorescence microscopy studies revealed that microtubules aggregated after HBMEC came in contact with C. freundii; furthermore, the microtubule aggregation was time dependent and seen with C. freundii but not with noninvasive E. coli HB101 and meningitic E. coli K1. Also in contrast to other meningitis-causing bacteria, C. freundii is able to replicate within HBMEC. This is the first demonstration of a meningitis-causing bacterium capable of intracellular replication within BMEC. The important determinants of the pathogenesis of C. freundii causing meningitis and brain abscess may relate to invasion of and intracellular replication in HBMEC.

  14. Pilot study to evaluate the role of Mycoplasma species in cat bite abscesses.

    PubMed

    Torres-Henderson, Camille; Hesser, Jeff; Hyatt, Doreene R; Hawley, Jennifer; Brewer, Melissa; Lappin, Michael R

    2014-12-01

    Mycoplasma species are common inhabitants of the feline oral cavity, and so likely contaminate many cat bite abscesses. The objectives of this study were to determine whether Mycoplasma species are common contaminants of cat bite abscesses and whether they are are associated with β-lactam-resistant clinical disease. Twenty-six privately owned cats with clinical evidence of an abscess suspected to be from a cat bite were included in the study. Samples from each cat were evaluated by aerobic and anaerobic culture, as well as Mycoplasma species culture and polymerase chain reaction (PCR). All cats were initially treated with appropriate wound management and were administered an antibiotic of the β-lactam class (amoxicillin, amoxicillin clavulanate or cefovecin sodium). Mycoplasma species DNA was amplified by PCR from 4/26 samples (15.4%); one of these cases was concurrently culture positive. Adequate DNA for sequencing was present for 2/4 positive PCR samples; one was most homologous with Mycoplasma felis, and the other was most homologous with Mycoplasma equigenitalium and Mycoplasma elephantis. Of the 26 cats, 25 responded to the initial treatment by day 7. The cat that failed initial treatment was positive for M equigenitalium or M elephantis DNA on days 0 and 12, and ultimately responded to administration of enrofloxacin and clindamycin. The results suggest that while Mycoplasma species can contaminate cat bite abscesses, routine wound management and β-lactam antibiotic therapy is adequate for treatment in most cases of abscess. However, as Mycoplasma species infections do not respond to β-lactam class antibiotic therapy, these organisms should be on the differential list for cats with abscesses that fail treatment with this antibiotic class. PMID:24643287

  15. Pilot study to evaluate the role of Mycoplasma species in cat bite abscesses.

    PubMed

    Torres-Henderson, Camille; Hesser, Jeff; Hyatt, Doreene R; Hawley, Jennifer; Brewer, Melissa; Lappin, Michael R

    2014-12-01

    Mycoplasma species are common inhabitants of the feline oral cavity, and so likely contaminate many cat bite abscesses. The objectives of this study were to determine whether Mycoplasma species are common contaminants of cat bite abscesses and whether they are are associated with β-lactam-resistant clinical disease. Twenty-six privately owned cats with clinical evidence of an abscess suspected to be from a cat bite were included in the study. Samples from each cat were evaluated by aerobic and anaerobic culture, as well as Mycoplasma species culture and polymerase chain reaction (PCR). All cats were initially treated with appropriate wound management and were administered an antibiotic of the β-lactam class (amoxicillin, amoxicillin clavulanate or cefovecin sodium). Mycoplasma species DNA was amplified by PCR from 4/26 samples (15.4%); one of these cases was concurrently culture positive. Adequate DNA for sequencing was present for 2/4 positive PCR samples; one was most homologous with Mycoplasma felis, and the other was most homologous with Mycoplasma equigenitalium and Mycoplasma elephantis. Of the 26 cats, 25 responded to the initial treatment by day 7. The cat that failed initial treatment was positive for M equigenitalium or M elephantis DNA on days 0 and 12, and ultimately responded to administration of enrofloxacin and clindamycin. The results suggest that while Mycoplasma species can contaminate cat bite abscesses, routine wound management and β-lactam antibiotic therapy is adequate for treatment in most cases of abscess. However, as Mycoplasma species infections do not respond to β-lactam class antibiotic therapy, these organisms should be on the differential list for cats with abscesses that fail treatment with this antibiotic class.

  16. Pyogenic abscess after hepatic artery embolization: A rare but potentially lethal complication

    PubMed Central

    Mezhir, James J.; Fong, Yuman; Fleischer, Deborah; Seo, Susan K.; D’Amico, Francesco; Petre, Elena; Covey, Ann M.; Getrajdman, George I.; Thornton, Raymond H.; Solomon, Stephen B.; Jarnagin, William R.; Brown, Karen T.

    2016-01-01

    Background Hepatic artery embolization (HAE) is used commonly to treat liver tumors or hemorrhage. Infectious complications are rare, but carry high morbidity and mortality. Identification of clinical factors associated with post-embolization abscess may improve management and outcome. Methods Clinical and pathologic variables of patients treated with HAE were collected and analyzed to determine the etiology, incidence, and outcome of pyogenic hepatic abscess. Results From January 1998 to January 2010, 971 patients underwent 2,045 HAE procedures. Fourteen patients developed a pyogenic hepatic abscess following embolization for an overall rate of 1.4%. Thirty-four patients (4%) had a history of bilioenteric anastomosis (BEA) and 21 patients (2%) lacked a competent sphincter of Oddi due to the presence of a biliary stent (N=19) or a prior sphincterotomy (N=2). Eleven (33%) of the 34 patients with a BEA and 2 (10%) of 21 patients with an incompetent sphincter developed abscesses, in contrast to only 1 abscess (0.05%) among the 916 patients with apparently normal sphincters (0.1%, OR 437.6 (95% CI 54.2 – 3,533, p<0.0001). Gram negative and gram positive aerobes were the most common bacteria isolated following drainage. Percutaneous drainage was the initial management strategy in all patients; 2 patients (14%) required subsequent surgical drainage and hepatectomy and 3 (21%) died. Conclusion Pyogenic hepatic abscess is rare after HAE. A history of BEA or an incompetent sphincter of Oddi due to a biliary stent or prior sphincterotomy substantially increases in the likelihood of this highly morbid and potentially fatal complication. PMID:21195630

  17. Brain herniation

    MedlinePlus

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  18. Lung abscess combined with chronic osteomyelitis of the mandible successfully treated with video-assisted thoracoscopic surgery.

    PubMed

    Arai, Hiromasa; Inui, Kenji; Watanabe, Keisuke; Watanuki, Kei; Okudela, Koji; Tsuboi, Masahiro; Masuda, Munetaka

    2015-04-01

    With the progress of antibiotic therapy, the mortality of lung abscess has been improved, and surgical intervention has declined. However, surgery is still required in selected cases that are intractable to antibiotic treatment. Video-assisted thoracoscopic surgery (VATS) is beneficial for treatment and/or diagnosis of pulmonary disease as it provides a less invasive surgical technique and reduces prolongation of post-operative recovery. However, the indication of VATS lobectomy for lung abscess is controversial as a result of particular complications, i.e. wet lung, intrapleural adhesion and ease of bleeding. We herein report a rare combination of lung abscess and osteomyelitis of mandible resulting from the same pathogen successfully treated with VATS lobectomy. We propose VATS lobectomy for lung abscess. This procedure might be the best treatment candidate for selected cases of lung abscess.

  19. Idiopathic pontine Streptococcus salivarius abscess in an immunocompetent patient: management lessons through case illustration and literature review.

    PubMed

    Mandapat, Aimee Luna; Eddleman, Christopher S; Bissonnette, Mei Lin; Batjer, H Hunt; Zembower, Teresa R

    2011-12-01

    A 55-y-old woman with no previous medical history presented with a 3-day history of progressive headache, nausea, emesis, right-sided facial numbness, and right-sided extremity weakness. Serial magnetic resonance imaging demonstrated rapid enlargement of a left-sided ring-enhancing dorsal pontine lesion with an exophytic portion, raising concern for an abscess. A stereotactically guided left-sided retrosigmoid craniotomy for abscess incision and decompression was performed given the rapid progression of her neurological deficits. Streptococcus salivarius was isolated from the intra-operative samples. After an extensive evaluation, no source for the S. salivarius was identified. Solitary brainstem abscesses are uncommon intracranial infections with high morbidity and mortality. Patients can present with non-specific symptoms and often have no previous medical history. Since 1974, 40 patients with solitary brainstem abscess have survived to hospital discharge. We outline management strategies for solitary brainstem abscess based on a literature review of survivors. PMID:21756019

  20. [Pancreatic gas with no evidence of abscess. Report of 2 cases].

    PubMed

    Herrera-Ascencio, E; Uscanga, L; Fernández del Castillo, C; Robles-Diaz, G; Campuzano Fernández, M

    1991-01-01

    Intrapancreatic air has been considered a reliable sign of pancreatic abscess (PA), although it can also be associated with other pancreatic diseases. We report here the clinical outcome of two patients with acute pancreatitis with gas in the retrogastric region suggestive of an abscess. Both patients exhibited a good clinical course with no evidence of sepsis. They were treated with analgesics and one of them with antibiotics. Control CT scans showed disappearance of liquid collections and intrapancreatic gas. In one case an endoscopy disclosed a gastric ulcer with changes suggesting a pancreatic fistula. This report shows that intrapancreatic air may mimic PA in cases with acute pancreatitis without septic complications.