Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24.979
Filtrar
1.
Ann Saudi Med ; 41(5): 307-311, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34618603

RESUMO

Splenic abscess is an aggressive disease with a non-specific etiology and symptoms that are systemically detrimental. During the current COVID-19 pandemic, there has been a noted rise in the incidence of splenic abscesses. The aim of this article was to explore whether infection with the SARS-CoV-2 virus increases the risk of developing splenic abscesses. We reviewed three cases with SARS-CoV-2 infection who developed splenic abscess. The clinical characteristics, treatment course, management and outcome are reported. We perceived that hypercoagulability status, superimposing infections and immunosuppression were related to SARS-CoV-2 infection. These were common factors in these three observed cases of splenic abscess as a complication related to the new viral pandemic. SARS-CoV-2 infection might be a risk factor in development of splenic abscess. SIMILAR CASES PUBLISHED: To the best of our knowledge only one case similar to our case series was published.


Assuntos
COVID-19 , Esplenopatias , Abscesso/etiologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Esplenopatias/etiologia
2.
Zhonghua Er Ke Za Zhi ; 59(9): 777-781, 2021 Sep 02.
Artigo em Chinês | MEDLINE | ID: mdl-34645219

RESUMO

Objective: To explore the early clinical clues for diagnosis of chronic granulomatous disease (CGD). Methods: One hundred and thirty-nine children with CGD seen in Beijing Children's Hospital from January 2007 to October 2020 were included in this study. The clinical features including age of onset, first presentations, reason for being hospitalized, etiology, imaging features, clues for early diagnosis of all patients were evaluated retrospectively. According to the time of diagnosis, the patients were divided into two groups, cases diagnosed before 2015 and after 2015 and 2015. The time of diagnosis, the length of stay and the hospital charges were compared between the two groups. T test and χ2 test were used for statistical analyses. Results: One hundred and nineteen of the cases were males and 20 were females. The age of onset was 4 months (8 d to 14 years), and 103 cases (74.1%) had onset before 1 year of age. The age at diagnosis was 1.8 years (21 d to 14.7 years), and the time of diagnosis delay was 1 year (7 d to 13.7 years). One hundred and thirty-five cases (97.1%) had pulmonary infection as the main reason for hospitalization, of whom 76 cases (56.3%) had positive pulmonary etiology. One hundred and thirty-six patients (97.8%) were referred cases, of whom 5 were suspected of CGD before referral, and the misdiagnosis rate was as high as 96.3% (131/136). Eight early clues for diagnosis were found, the frequency from high to low, large bacillus Callmette-Guer scar in 99 cases (70.5%), left axillary lymphadenopathy or calcification in 73 cases (52.5%), skin or other lymph node infections in 58 cases (41.7%), skin scars in 50 cases (36.0%), multiple lung nodules in 42 cases (30.2%), perianal abscess in 35 cases (25.2%), pulmonary Aspergillus infection in 26 cases (18.7%) and pulmonary Burkholderia infection in 15 cases (10.8%). A total of 120 cases of CGD were diagnosed by respiratory burst test during hospitalization, including 55 cases diagnosed before 2015 and 65 cases diagnosed after 2015. After using these 8 early diagnosis clues, the cases diagnosed after 2015 had shorter time of diagnosis and the length of stay and lower hospitalization charge than cases diagnosed before 2014, and the difference was statistically significant ((25±7) vs. (10±5) d, (29±7) vs. (18±6) d, (3.7×104±1.2×104) vs. (3.2×104±1.2×104) Yuan, t=13.763, 9.262, 2.381, all P<0.05). Conclusions: Patients with CGD are younger at onset and the diagnosis is delayed. Pulmonary infections are the most common. Large BCG scar, left axillary lymphadenopathy or calcification, skin or other lymph node infections, skin scars, multiple lung nodules, perianal abscesses, pulmonary Aspergillus infection and Burkholderia infection can help early diagnosis of CGD.


Assuntos
Doença Granulomatosa Crônica , Pneumonia , Dermatopatias , Abscesso , Criança , Feminino , Doença Granulomatosa Crônica/diagnóstico , Doença Granulomatosa Crônica/epidemiologia , Humanos , Masculino , Estudos Retrospectivos
3.
Ann Palliat Med ; 10(9): 9830-9840, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628909

RESUMO

BACKGROUND: Surgery is the clinically preferred treatment for high perianal abscesses. Incision and seton drainage improve the cure rate and reduce recurrence. We aimed to systematically evaluate the clinical effect and safety of incision and seton drainage in the treatment of high perianal abscess. METHODS: China Knowledge Network (CNKI), WanFang database, VIP database, PubMed, and Cochrane Library were searched and all relevant Chinese and English language documents until July 2021were retrieved. All records that described randomized clinical trials (RCTs) of incision and seton drainage for the treatment of high perianal abscess were eligible. Documents that met the inclusion criteria were evaluated for bias using the Cochrane Collaboration Risk Evaluation Standard, and Revman5.4 software was used to analyze the data. RESULTS: Fourteen RCTs were included. The results of nine studies showed that the clinical cure rate of the incision-seton group was higher than that of the incision-drainage group (P<0.05). Seven studies showed that the wound healing time of the incision-seton group was shorter than that of the incision-drainage group (P<0.05). Four studies showed that the visual analogue scale (VAS) score of the incision-seton group was lower than that of the incision-drainage group (P<0.05). Five studies showed that the Wexner score of the incision-seton group was lower than that of the incision-drainage group (P<0.05). Six studies showed that the formation rate of anal fistula in the incision-seton group was lower than that in the incision-drainage group (P<0.05). Six studies demonstrated that the recurrence rate of abscess in the incision-seton group was lower than that in the incision-drainage group (P<0.05). Seven studies showed that the incidence of adverse events in the incision-seton group was lower than that in the incision-drainage group (P<0.05). Five studies demonstrated that the length of stay in the incision-seton group was shorter than that of the incision-drainage group (P<0.05). DISCUSSION: The choice of surgical methods in clinical research has always been controversial. The incision-seton method can effectively and safely treat high perianal abscess. However, the results of this meta-analysis still leave some gaps in the evidence. More large-sample, high-quality, and multi-center RCTs are needed.


Assuntos
Doenças do Ânus , Fístula Retal , Abscesso/cirurgia , Doenças do Ânus/cirurgia , Drenagem , Humanos , Recidiva
4.
Z Gastroenterol ; 59(10): 1053-1058, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34638153

RESUMO

BACKGROUND: Drainage is essential for source control of the infection in a pelvic abscess. The purpose of this study was to report 2 cases of endoscopic ultrasound (EUS)-guided drainage of the pelvic abscess and review the literature of different modalities of EUS-guided drainage of pelvic abscess. CASE PRESENTATION: A 60-year-old male developed a pelvic abscess 1 month after laparoscopic complete tumor resection. An abdominal CT showed a mass shadow (about 7.1 cm × 5.1 cm) in the right pelvic region. Another case was an 85-year-old male who developed a pelvic abscess 3 days after recurrent tumor resection of multiple organs. The CT showed pelvic effusion and gas accumulation (approximately 6.5 cm × 4.2 cm), and the intestinal tube above the small intestinal anastomosis was dilated with effusion. A 19G-A puncture needle was used to puncture the abscess. An 8-mm cylindrical balloon was inserted, followed by a 10 Fr-3 cm double pigtail stent and an 8.5 Fr drainage tube. After EUS-guided drainage of pelvic abscess, the symptoms disappeared without recurrence. CONCLUSIONS: EUS-guided drainage is an effective and safe method for treating pelvic abscesses as long as the drainage modality is appropriately selected based on the etiology, size, and mucus viscosity of the abscess.


Assuntos
Abscesso , Endossonografia , Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Idoso de 80 Anos ou mais , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Pelve/cirurgia , Ultrassonografia de Intervenção
5.
Z Gastroenterol ; 59(10): 1078-1082, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34638154

RESUMO

Eosinophilic esophagitis is an important differential diagnosis in the presence of dysphagia or bolus obstruction of the esophagus. Delayed diagnosis of eosinophilic esophagitis can lead to strictures of the esophagus.We report on a young patient who presented with initially unclear retrosternal symptoms to our department. The diagnosis of eosinophilic esophagitis, complicated by an intramural abscess of the esophagus, was established. After spontaneous drainage of the abscess, antibiotic therapy and subsequent remission induction of eosinophilic esophagitis with orodispersible budesonide resulted in a good therapeutic outcome.


Assuntos
Transtornos de Deglutição , Esofagite Eosinofílica , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Diagnóstico Diferencial , Esofagite Eosinofílica/complicações , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/tratamento farmacológico , Humanos
6.
Hinyokika Kiyo ; 67(9): 427-431, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34610709

RESUMO

A 70-year-old man visited his doctor because of hip pain and gross hematuria. Digital rectal examination and computed tomography revealed a prostatic abscess. Although antibiotics were prescribed, his symptoms did not improve; he was transferred to our hospital, where transurethral fenestration of the prostatic abscess was performed. During prostatic fenestration, a papillary mucous membrane was confirmed inside the cavity of the prostatic abscess. Pathological examination revealed a mucinous adenocarcinoma of the prostate. Although hormonal therapy was administered, magnetic resonance imaging revealed tumor extension necessitating robot-assisted radical prostatectomy. Mucinous adenocarcinoma of the prostate is rare, and to our knowledge this is the first report of mucinous adenocarcinoma of the prostate diagnosed after transurethral treatment of a prostatic abscess.


Assuntos
Adenocarcinoma Mucinoso , Doenças Prostáticas , Neoplasias da Próstata , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Abscesso/cirurgia , Adenocarcinoma Mucinoso/cirurgia , Idoso , Humanos , Masculino , Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/cirurgia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia
7.
BMJ Case Rep ; 14(9)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34548300

RESUMO

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are rare tumours of gastrointestinal tract, extremely rare in anal canal. We report a case of misdiagnosed MiNEN in a 38-year-old woman initially conservatively treated for a supposed anal fistula. In a second proctological evaluation, biopsy of the anal neoformation was performed and the histological specimen diagnosed a MiNEN. The complete staging showed a disseminate disease and the patient started a chemotherapy schedule. After 6 months, stable disease was revealed at the last imaging performed and radical surgery was offered to the patient that is actually on oncological follow-up without recurrence at 1 year.


Assuntos
Canal Anal , Carcinoma Neuroendócrino , Abscesso/diagnóstico por imagem , Adulto , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/cirurgia , Erros de Diagnóstico , Feminino , Humanos , Recidiva Local de Neoplasia
8.
BMJ Case Rep ; 14(9)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34588202

RESUMO

A 16-year-old man was hospitalised with a painful space-occupying lesion in his posterior neck involving muscles, soft tissues, C1 cervical vertebra and vital cervical blood vessels. The true-cut biopsy showed inflammatory tissue. The microbiological analysis, which combined classical bacteriological and molecular methods, yielded at least four different anaerobic species. The patient was treated successfully with a prolonged course of ceftriaxone and metronidazole.


Assuntos
Abscesso , Osteomielite , Abscesso/diagnóstico por imagem , Abscesso/tratamento farmacológico , Adolescente , Ceftriaxona , Vértebras Cervicais/diagnóstico por imagem , Humanos , Masculino , Pescoço , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico
9.
Med J Malaysia ; 76(5): 768-770, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34508393

RESUMO

Luc's abscess is an exceedingly rare complication of otitis media, where the middle ear infection spreads extratemporally causing a subperiosteal collection under the temporalis muscle. It is known as a benign complication of otitis media as it is thought not to involve the mastoid bone in comparison to other types of extratemporal abscesses related to otitis media. We describe a challenging case of a 19-year-old male with Down syndrome diagnosed with Luc's abscess involving the mastoid bone. A high-resolution computed tomography scan is important to determine the extent of the abscess, with or without mastoid involvement, and the presence of complications. These findings will then help to determine the surgical options. Drainage of abscesses is a simple, initial, and conservative approach but less effective compared to mastoidectomy. 'Mastoidsparing' approach should only be considered if there is complete resolution after a simple drainage and antibiotic treatment.


Assuntos
Síndrome de Down , Otite Média , Abscesso/diagnóstico por imagem , Abscesso/tratamento farmacológico , Abscesso/etiologia , Adulto , Antibacterianos/uso terapêutico , Síndrome de Down/complicações , Drenagem , Humanos , Masculino , Processo Mastoide , Otite Média/complicações , Adulto Jovem
10.
Arch Argent Pediatr ; 119(5): e540-e544, 2021 10.
Artigo em Espanhol | MEDLINE | ID: mdl-34569759

RESUMO

The infection by Bartonela henselae (BH), the cause of cat scratch disease, it could be asymptomatic or produce local and multisystem illness. The objective of this case report is to document that the hepato-splenic involvement is unusual in BH infection, and the treatment is discussed and individualized in each patient. This case is about an eleven-year girl who presented with findings in abdominal tomography and ultrasound of hepato-splenic abscesses, with later positive serology for BH. In this way, a bibliographic review is carried out to show the low prevalence and incidence of hepato-splenic involvement where the anamnesis and the physical examination are essential to make an early diagnosis and treatment.


Assuntos
Bartonella henselae , Doença da Arranhadura de Gato , Esplenopatias , Abscesso , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/diagnóstico , Humanos , Fígado , Esplenopatias/diagnóstico por imagem
12.
J Int Med Res ; 49(9): 3000605211027442, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34586877

RESUMO

OBJECTIVE: To present the clinical characteristics, diagnostics, and treatments for Brucella prostatic abscess (BPA). METHODS: We retrospectively analyzed eight BPA patients according to their vocations, age, clinical manifestations, laboratory test results, magnetic resonance imaging (MRI) findings, and treatments. RESULTS: The median age was 59 years. The most common clinical symptom was fever, followed by dysuria, erectile dysfunction, frequent urination, and urodynia. C-reactive protein (CRP) concentrations were significantly elevated in all patients, and in all by one patient, the erythrocyte sedimentation rate (ESR) was high. Prostate enlargement occurred in 87.5% of the patients. Lesions were located in the prostate peripheral (87.5%) and central zones (100%), with homogenous signals on T1-weighted imaging (T1WI) and a hyperintense signal on short tau inversion recovery (STIR). Patients had a small nodule or multiple nodules, with slight hyperintense to hyperintense signals on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI). Three patients had pelvic effusion, and seminal vesicle (37.5%), epididymis (12.5%), and bladder (12.5%) infections occurred. All patients received rifampicin and doxycycline with levofloxacin; all lesions had resolved at follow-up ultrasonography. CONCLUSION: Even in epidemic areas, the incidence of BPA is relatively rare. Our findings may increase the understanding of BPA and reduce misdiagnosis and mistreatment.


Assuntos
Brucella , Abscesso/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
J Med Case Rep ; 15(1): 455, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34517890

RESUMO

BACKGROUND: Cauda equina syndrome is a rare clinical condition that requires prompt diagnosis and timely surgical decompression with postoperative rehabilitation to prevent devastating complications. CASE PRESENTATION: A 55-year-old Sinhalese woman presented with a vulval abscess, with a history of involuntary leakage of urine for the last 7 years. Her sexual activity has been compromised due to coital incontinence, and she had also been treated for recurrent urinary tract infections during the last 7 years. On examination, a distended bladder was found. Neurological examination revealed a saddle sensory loss of S2-S4 dermatomes. There was no sensory loss over the lower limbs. Bladder sensation was absent, but there was some degree of anal sphincter tone. Motor functions and reflexes were normal in the limbs. Magnetic resonance imaging revealed L5-S1 spondylolisthesis. Ultrasound imaging confirmed the finding of a distended bladder, in addition to bilateral hydroureters with hydronephrosis. An incision and drainage with concomitant intravenous antibiotics were started for the vulval abscess. An indwelling catheter was placed to decompress the bladder and to reduce vulval excoriations due to urine. Bilateral ureteric stenting was performed later for persistent hydronephrosis and hydroureter despite an empty bladder. CONCLUSION: This is a tragic case that illustrates the devastating long-term sequelae that ensues if cauda equina syndrome is left undiagnosed. It reiterates the importance of prompt referral and surgical decompression.


Assuntos
Cauda Equina , Polirradiculopatia , Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Descompressão Cirúrgica , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Polirradiculopatia/diagnóstico por imagem , Polirradiculopatia/etiologia , Polirradiculopatia/cirurgia
14.
BMJ Case Rep ; 14(9)2021 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-34511419

RESUMO

Mycobacterium kansasii is among the most common non-tuberculous mycobacteria causing human infections. Apart from pulmonary infection, the most common infection caused by M. kansasii is skin and soft tissue infection, and it is very rare in immunocompetent people. In this report, we present a case of a huge cutaneous abscess caused by M. kansasii A 63-year-old man living in Bangkok presented with progressive pain at the left lateral chest wall for 3 weeks and altered mentation for a few days. Examination revealed a non-tender fluctuated cutaneous mass 20×10 cm in size. An aspiration of the mass yielded 50 mL pus with many positive acid-fast bacilli. Mycobacterial PCR was positive for M. kansasii with culture confirmation. There was severe hypercalcaemia. The treatment included surgical drainage, and medical treatment consisted of isoniazid, rifampicin, ethambutol and levofloxacin, along with adequate hydration and calcitonin for hypercalcaemia. The patient gradually improved and was discharged 12 days after hospitalisation.


Assuntos
Hipercalcemia , Infecções por Mycobacterium não Tuberculosas , Mycobacterium kansasii , Abscesso/complicações , Abscesso/tratamento farmacológico , Humanos , Hipercalcemia/etiologia , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Tailândia
15.
Rozhl Chir ; 100(7): 325-329, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465108

RESUMO

Skin abscess is one of the most common infections of skin and soft tissues. Incision and drainage under local anesthesia is the mainstay of treatment. Although previous small-scale studies failed to show a benefit of antibiotics in patients with simple abscesses, the use of antibiotic therapy is still encountered in the treatment of uncomplicated skin abscesses in our practice. The purpose of our study was to evaluate existing data assessing the effect of adjuvant antibiotic therapy on abscess management. Although as indicated by two recent multicenter studies, antibiotics may provide a positive effect in the management, it is important to consider the risk of resistance associated with antibiotic overuse and to approach each case individually.


Assuntos
Abscesso , Infecções dos Tecidos Moles , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Antibacterianos/uso terapêutico , Terapia Combinada , Drenagem , Humanos
16.
Cochrane Database Syst Rev ; 8: CD010168, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34402522

RESUMO

BACKGROUND: This is the second update of a Cochrane Review first published in 2015 and last updated in 2018. Appendectomy, the surgical removal of the appendix, is performed primarily for acute appendicitis. Patients who undergo appendectomy for complicated appendicitis, defined as gangrenous or perforated appendicitis, are more likely to suffer postoperative complications. The routine use of abdominal drainage to reduce postoperative complications after appendectomy for complicated appendicitis is controversial. OBJECTIVES: To assess the safety and efficacy of abdominal drainage to prevent intraperitoneal abscess after appendectomy (irrespective of open or laparoscopic) for complicated appendicitis; to compare the effects of different types of surgical drains; and to evaluate the optimal time for drain removal. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid Embase, Web of Science, the World Health Organization International Trials Registry Platform, ClinicalTrials.gov, Chinese Biomedical Literature Database, and three trials registers on 24 February 2020, together with reference checking, citation searching, and contact with study authors to identify additional studies. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) that compared abdominal drainage versus no drainage in people undergoing emergency open or laparoscopic appendectomy for complicated appendicitis. We also included RCTs that compared different types of drains and different schedules for drain removal in people undergoing appendectomy for complicated appendicitis. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. Two review authors independently identified the trials for inclusion, collected the data, and assessed the risk of bias. We used the GRADE approach to assess evidence certainty. We included intraperitoneal abscess as the primary outcome. Secondary outcomes were wound infection, morbidity, mortality, hospital stay, hospital costs, pain, and quality of life. MAIN RESULTS: Use of drain versus no drain We included six RCTs (521 participants) comparing abdominal drainage and no drainage in participants undergoing emergency open appendectomy for complicated appendicitis. The studies were conducted in North America, Asia, and Africa. The majority of participants had perforated appendicitis with local or general peritonitis. All participants received antibiotic regimens after open appendectomy. None of the trials was assessed as at low risk of bias. The evidence is very uncertain regarding the effects of abdominal drainage versus no drainage on intraperitoneal abscess at 30 days (risk ratio (RR) 1.23, 95% confidence interval (CI) 0.47 to 3.21; 5 RCTs; 453 participants; very low-certainty evidence) or wound infection at 30 days (RR 2.01, 95% CI 0.88 to 4.56; 5 RCTs; 478 participants; very low-certainty evidence). There were seven deaths in the drainage group (N = 183) compared to one in the no-drainage group (N = 180), equating to an increase in the risk of 30-day mortality from 0.6% to 2.7% (Peto odds ratio 4.88, 95% CI 1.18 to 20.09; 4 RCTs; 363 participants; low-certainty evidence). Abdominal drainage may increase 30-day overall complication rate (morbidity; RR 6.67, 95% CI 2.13 to 20.87; 1 RCT; 90 participants; low-certainty evidence) and hospital stay by 2.17 days (95% CI 1.76 to 2.58; 3 RCTs; 298 participants; low-certainty evidence) compared to no drainage. The outcomes hospital costs, pain, and quality of life were not reported in any of the included studies. There were no RCTs comparing the use of drain versus no drain in participants undergoing emergency laparoscopic appendectomy for complicated appendicitis. Open drain versus closed drain There were no RCTs comparing open drain versus closed drain for complicated appendicitis. Early versus late drain removal There were no RCTs comparing early versus late drain removal for complicated appendicitis. AUTHORS' CONCLUSIONS: The certainty of the currently available evidence is low to very low. The effect of abdominal drainage on the prevention of intraperitoneal abscess or wound infection after open appendectomy is uncertain for patients with complicated appendicitis. The increased rates for overall complication rate and hospital stay for the drainage group compared to the no-drainage group are based on low-certainty evidence. Consequently, there is no evidence for any clinical improvement with the use of abdominal drainage in patients undergoing open appendectomy for complicated appendicitis. The increased risk of mortality with drainage comes from eight deaths observed in just under 400 recruited participants. Larger studies are needed to more reliably determine the effects of drainage on morbidity and mortality outcomes.


Assuntos
Abscesso/prevenção & controle , Apendicectomia/efeitos adversos , Apendicite/cirurgia , Drenagem/métodos , Peritonite/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Humanos
17.
Can Vet J ; 62(8): 877-881, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34341604

RESUMO

A 3-month-old foal with a history of acute hematuria was evaluated. Hydronephrosis and hydroureter were visualized upon renal ultrasonography of the left kidney. Cystoscopy identified a blood clot occluding the left ureter. Computed tomography (CT) revealed a large retroperitoneal abscess at the level of the aortic bifurcation and a left internal iliac aneurysm. Due to the severity of the lesions and the poor prognosis, the filly was euthanized and the clinical findings were confirmed by post-mortem examination. This report emphasizes the value of obtaining a precise diagnosis via CT in order to avoid unviable treatment approaches when confronted with this unusual secondary complication of omphaloarteritis. Key clinical message: Umbilical complications are routinely diagnosed in equine neonatal medicine, and commonly lead to septicemia, physitis, and septic arthritis; severe internal umbilical abscessation, and subsequent vascular and urinary disorders are uncommon sequelae.


Assuntos
Doenças dos Cavalos , Aneurisma Ilíaco , Abscesso/diagnóstico , Abscesso/veterinária , Animais , Eutanásia Animal , Feminino , Hematúria/etiologia , Hematúria/veterinária , Doenças dos Cavalos/diagnóstico , Cavalos , Aneurisma Ilíaco/diagnóstico por imagem , Aneurisma Ilíaco/veterinária , Artéria Ilíaca/diagnóstico por imagem
20.
BMJ Case Rep ; 14(8)2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34426431

RESUMO

A 56-year-old man was admitted to intensive care with septic shock, multiple facial abscesses and thrombophlebitis of the right internal jugular vein with extensive intracranial extension. A diagnosis of Lemierre syndrome due to Streptococcus anginosus was made and treatment initiated with high-dose ceftriaxone and metronidazole, along with surgical debridement. His admission was complicated by raised intraocular pressures and visual loss requiring bilateral canthotomies. Despite therapeutic anticoagulation with enoxaparin, he also developed an ischaemic basal ganglia infarct. After a prolonged and complex hospital stay, the patient was later readmitted with an intracerebral abscess requiring surgical excision and a second course of antibiotics. This case highlights the value of early recognition of this rare but potentially life-threatening condition, considerations around anticoagulation and antibiotic decisions, and the importance of close multidisciplinary follow-up even after discharge from hospital.


Assuntos
Síndrome de Lemierre , Tromboflebite , Abscesso/complicações , Abscesso/cirurgia , Antibacterianos/uso terapêutico , Humanos , Veias Jugulares , Síndrome de Lemierre/complicações , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/tratamento farmacológico , Masculino , Pessoa de Meia-Idade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...