RESUMO
Recipients of solid-organ transplants are, due to immunosuppressive treatment, disposed to opportunistic infections including tuberculosis. We report a rare case of acute intramedullary tuberculous abscess in a Danish male recipient of a liver transplant. The problems in diagnostics, medical and surgical treatment are discussed.
Assuntos
Transplante de Fígado , Tuberculose da Coluna Vertebral/etiologia , Abscesso/patologia , Antituberculosos/administração & dosagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Medula Espinal/patologia , Tuberculose da Coluna Vertebral/diagnóstico , Tuberculose da Coluna Vertebral/tratamento farmacológico , Tuberculose da Coluna Vertebral/imunologiaRESUMO
Fifty-nine patients were operated or punctured in 60 incidents of brain abscess from 1963-1989, twice as many in men as in women. The number of cases tripled in 1980 to an incidence of 3.6 per million inhabitants per year, supposedly due to the advent of computerized tomography. Simultaneously, the aetiology changed from staphylococci and Gram negative rods to dominance of streptococci and Haemophilus aphrophilus. Apart from temporal abscesses, there was no correlation between localisation in the brain and the bacterial species isolated. Ninety-five per cent of the specimens from untreated patients gave growth, but so did specimens from six of 18 patients treated with relevant antibiotics up to 11 days before puncture. Therefore, we recommend removal of pus by excision or puncture.
Assuntos
Infecções por Bacteroides/epidemiologia , Abscesso Encefálico/microbiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Haemophilus/epidemiologia , Adolescente , Adulto , Idoso , Ampicilina/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Abscesso Encefálico/epidemiologia , Cefotaxima/uso terapêutico , Criança , Pré-Escolar , Cloranfenicol/uso terapêutico , Dinamarca , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meticilina/uso terapêutico , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Penicilinas/uso terapêutico , Estudos Retrospectivos , Estreptomicina/uso terapêutico , Sulfonamidas/uso terapêuticoRESUMO
Injury to retroperitoneal vascular structures secondary to lumbar disc surgery is a rare but serious complication. In some cases early recognition and surgical intervention is of vital importance. Vascular injuries may be classified in in the following manner. 1. Laceration of one artery or a vein only. 2. Laceration of a artery and a vein leading to formation of arteriovenous fistula. 3. False aneurysm. Based on a review of the literature and three case reports, the anatomy is reviewed. The diagnosis, clinical pictures and the vascular reconstruction are discussed.
