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1.
Medicine (Baltimore) ; 99(9): e19391, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118790

RESUMO

RATIONALE: The emphysematous prostatic abscess is a rare but potentially life-threatening clinical condition. The early diagnosis is difficult due to nonspecific symptoms. PATIENT CONCERNS: A 72-year-old man with poorly controlled diabetes mellitus was admitted to hospital because of dysuria and acute urine retention. He had a refractory fever after admission. DIAGNOSES: The diagnosis of emphysematous prostatic abscess was confirmed by culture of catheterized urine and pelvic CT. INTERVENTIONS: We tried to give antimicrobial treatment and control of blood glucose at first, but the infection could not be controlled by antibiotic therapy and control of blood glucose. TRUS-guided aspiration was performed, but obviously not adequate for abscess drainage and the abscess progressed. TUR was then performed and the infection was gradually controlled. OUTCOMES: Pelvic CT scan 1 month after discharge showed complete resolution of the EPA. LESSONS: Given the poor conservative treatment effect of emphysematous prostatic abscesses, CT or TRUS should be performed in the patients with suspected diagnosis. Early and appropriate drainage with proper antibiotic therapy is important to achieve a favorable outcome.


Assuntos
Abscesso/etiologia , Candidíase/complicações , Próstata/anormalidades , Abscesso/cirurgia , Idoso , Antibacterianos/uso terapêutico , Candida tropicalis/efeitos dos fármacos , Candida tropicalis/patogenicidade , Candidíase/tratamento farmacológico , Disuria/etiologia , Humanos , Masculino , Próstata/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Retenção Urinária/etiologia
3.
Ann R Coll Surg Engl ; 102(2): e45-e47, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31538802

RESUMO

Parapharyngeal infections carry a significant risk of extensive suppuration and airway compromise. We report the case of a patient presenting with a right paranasopharyngeal abscess, featuring atypical symptoms that made diagnosis particularly challenging. Complications included evidence of right vocal cord paralysis, likely secondary to involvement of the vagus nerve. Notably, this paralysis occurred in isolation, without involvement of cranial nerves IX or XI, which would be expected from jugular foramen encroachment. Imaging demonstrated the presence of a collection extending towards the skull base, which was drained using a transnasal endoscopic approach, avoiding the use of external incisions. Tissue biopsies from the abscess wall suggest that the underlying aetiology was minor salivary gland sialadenitis, which has not been previously reported in the literature.


Assuntos
Abscesso/etiologia , Doenças Faríngeas/etiologia , Sialadenite/complicações , Paralisia das Pregas Vocais/etiologia , Abscesso/diagnóstico , Abscesso/cirurgia , Adolescente , Biópsia , Drenagem , Endoscopia , Feminino , Humanos , Imagem por Ressonância Magnética , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Nasofaringe/diagnóstico por imagem , Nasofaringe/patologia , Doenças Faríngeas/diagnóstico , Doenças Faríngeas/cirurgia , Nervo Laríngeo Recorrente/diagnóstico por imagem , Glândulas Salivares Menores/patologia , Sialadenite/diagnóstico , Sialadenite/patologia , Base do Crânio/diagnóstico por imagem , Base do Crânio/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Paralisia das Pregas Vocais/diagnóstico
4.
Isr Med Assoc J ; 12(21): 806-811, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31814344

RESUMO

BACKGROUND: Untreated dental caries or even dental manipulations, such as a tooth extraction, might cause direct spread of an odontogenic infection and consequently the development of life-threatening conditions such as deep neck infections (DNI). The most common source of DNI is of odontogenic origin (38.8-49%). Abscess formation or cellulitis can lead to life-threatening complications, despite new diagnostic imaging technology and widespread availability of antibiotics. OBJECTIVES: To demonstrate the dangers of DNI, which can create life-threatening situations. METHODS: Five cases of DNI of odontogenic origin, which were referred to the oral and maxillofacial surgery unit, are presented. RESULTS: Clinical manifestations included trismus, dysphagia, dysphonia, dyspnea, and infection symptoms. In all cases, computed tomography confirmed diagnosis and extent of abscess. Complications included mediastinitis, respiratory distress, osteomyelitis of the jaws, and in rare cases the mandibular condyle. Treatment included securing the airway, immediate surgical drainage, removal of the infection source, and antibiotic therapy. All patients were discharged in stable and improved condition. CONCLUSIONS: DNI treatment on an emergency basis requires proper diagnosis and effective management. To confirm diagnosis and prevent serious complications, it is essential for physicians to recognize the spaces of the head and neck that are likely to be affected by DNI.


Assuntos
Abscesso , Antibacterianos/administração & dosagem , Celulite (Flegmão) , Cárie Dentária/complicações , Drenagem/métodos , Pescoço , Procedimentos Cirúrgicos Bucais/métodos , Extração Dentária/efeitos adversos , Abscesso/diagnóstico , Abscesso/etiologia , Abscesso/fisiopatologia , Abscesso/cirurgia , Adulto , Idoso , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/etiologia , Celulite (Flegmão)/fisiopatologia , Celulite (Flegmão)/cirurgia , Feminino , Humanos , Masculino , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastinite/terapia , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Pescoço/patologia , Osteomielite/diagnóstico , Osteomielite/etiologia , Osteomielite/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
5.
BMJ Case Rep ; 12(10)2019 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-31586950

RESUMO

Periprostatic abscess is a rare complication of hydrogel spacers in radiotherapy for prostate cancer. We present the case of a 61-year-old man who developed this condition. Abdominopelvis CT scan revealed a 54×35×75 mm collection in the location of the SpaceOAR, for which ultrasound-guided transperineal percutaneous drainage of the periprostatic abscess was performed. The patient remains well with serial CT scans showing near resolution of the collection.


Assuntos
Abscesso/diagnóstico , Hidrogéis/efeitos adversos , Doenças Prostáticas/diagnóstico , Lesões por Radiação/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus anginosus/isolamento & purificação , Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/cirurgia , Neoplasias da Próstata/radioterapia , Lesões por Radiação/diagnóstico por imagem , Lesões por Radiação/cirurgia , Infecções Estreptocócicas/diagnóstico por imagem , Infecções Estreptocócicas/cirurgia , Tomografia Computadorizada por Raios X
6.
Orv Hetil ; 160(42): 1677-1681, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31608692

RESUMO

Migration of swallowed foreign bodies from the gastrointestinal tract is a rare phenomenon compared with the total number of ingestions. In the reported two cases, the serious septic condition indicated urgent surgical intervention. We found a piece of wire swallowed a few months earlier in the right lobe of the liver and the retroperitoneum in case one, and a piece of wire in the pericardium, which migrated from the stomach through the left lobe of the liver, in case two. Abscesses and phlegmonae were found in the retroperitoneum and then in the femoral region requiring a reoperation in case one, and in the liver and pericardium in case two. After the evacuation of abscesses, both patients made full recovery. Diagnostic difficulties and therapeutic challenges served the reasons to present these cases. Orv Hetil. 2019; 160(42): 1677-1681.


Assuntos
Abscesso/complicações , Corpos Estranhos/diagnóstico por imagem , Migração de Corpo Estranho/diagnóstico por imagem , Fígado/diagnóstico por imagem , Pericárdio/diagnóstico por imagem , Trato Gastrointestinal Superior/diagnóstico por imagem , Abscesso/cirurgia , Adulto , Feminino , Corpos Estranhos/cirurgia , Migração de Corpo Estranho/cirurgia , Trato Gastrointestinal , Humanos , Pessoa de Meia-Idade , Radiografia , Estômago , Resultado do Tratamento , Trato Gastrointestinal Superior/cirurgia
7.
Medicine (Baltimore) ; 98(39): e17365, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574884

RESUMO

RATIONALE: Periorbital cellulitis or an orbital abscess caused by acute sinusitis is a serious acute infectious disease. If not treated in time, serious complications may occur. PATIENT CONCERNS: A 16-year-old girl with a history of right-sided proptosis, periorbital swelling, chemosis, hypophasis, restricted ocular movement in the upward direction, and diminution of vision was referred to our institution. The clinic, computed tomography (CT) and magnetic resonance imaging (MRI) examination indicate right orbital abscess in the upper quadrant and sinusitis. DIAGNOSES: She was diagnosed with orbital abscess, acute sinusitis. INTERVENTIONS: She underwent medical management, transnasal endoscopic surgery and then ultrasound-guided fine needle aspiration (FNA) and catheter drainage. OUTCOMES: She was completely cured without any complications or sequelae. LESSONS: Performance of surgical drainage in a timely manner and administration of effective antibiotic treatment according to bacterial culture can reduce the complications of orbital abscesses. Ultrasound-guided FNA and catheter drainage is a safe, simple, and effective method for the treatment of orbital abscess.


Assuntos
Abscesso/cirurgia , Drenagem/métodos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Doenças Orbitárias/cirurgia , Sinusite/cirurgia , Abscesso/microbiologia , Doença Aguda , Adolescente , Cateteres , Drenagem/instrumentação , Feminino , Humanos , Doenças Orbitárias/microbiologia , Sinusite/microbiologia
8.
J Ayub Med Coll Abbottabad ; 31(3): 464-465, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31535530

RESUMO

Tuberculosis continues to be a fatal infectious disease in developing countries. Despite the advances in medical sciences and introduction of potent therapeutic regimes tuberculosis has still managed to survive and prevail worldwide. It can affect many organs of body. Isolated splenic tuberculosis is uncommon in immunocompetent host and only some cases are reported internationally. Extrapulmonary tuberculosis with splenic involvement is also rare and only comes after lungs and liver. We present a case of patient presented with complaints of prolonged fever, cough and insidious onset of abdominal pain and sepsis. Exploratory laparotomy revealed spleenic abscess as incidental finding associated with tuberculous perforation of colon. She underwent double barrel colostomy and spleenectomy followed by intensive care unit admission. Measures such as awareness about the disease, early medical assistance and good compliance regarding treatment can produce positive results in combating tuberculosis and its complications.


Assuntos
Abscesso/microbiologia , Doenças do Colo/complicações , Perfuração Intestinal/microbiologia , Esplenopatias/microbiologia , Tuberculose/complicações , Abscesso/cirurgia , Idoso de 80 Anos ou mais , Doenças do Colo/cirurgia , Colostomia , Feminino , Humanos , Perfuração Intestinal/cirurgia , Esplenectomia , Esplenopatias/cirurgia , Tuberculose/cirurgia
9.
Turk J Pediatr ; 61(1): 40-43, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559720

RESUMO

Zhu Y, Xu F. The pathogens and curative effects analysis of perianal abscess of infants under 3 months. Turk J Pediatr 2019; 61: 40-43. In order to guide clinical treatment for perianal abscess of young infants, the characteristics of pathogens and curative effects analysis were conducted. Bacterial culture results, antibiotics susceptibility tests and curative effects of abscess incision were retrospectively analyzed in 66 cases of perianal abscess of infants under 3 months. There were 48 cases of Klebsiella pneumoniae, 7 cases of Staphylococcus, 6 cases of Escherichia coli, 5 cases of Proteus in the pathogen culture results. Klebsiella pneumoniae, the predominant pathogen, was susceptible to most antibiotics, especially to imipenem, cefoperazonesulbactam and amikacin with low drug resistance rates. However, high drug resistance rates were found to ampicillin and nitrofurantion. After abscess incision, the complication rate of anal fistula was 6.6% in infants under 3 months and 60.3% in the adult group. There was significant difference P<0.01. In conclusion, Klebsiella pneumoniae was the most common pathogen in perianal abscess of infants under 3 months and was commonly resistant to ampicillin and nitrofurantion. Since perianal abscess of infants under 3 months is a self-limited disorder, simple surgical intervention and synchronous sensitive antibiotic administration are suggested as the optimal management.


Assuntos
Abscesso , Doenças do Ânus , Infecções por Escherichia coli , Infecções por Klebsiella , Klebsiella pneumoniae/isolamento & purificação , Infecções Estafilocócicas , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Abscesso/cirurgia , Adulto , Antibacterianos/uso terapêutico , Doenças do Ânus/diagnóstico , Doenças do Ânus/tratamento farmacológico , Doenças do Ânus/microbiologia , Doenças do Ânus/cirurgia , Terapia Combinada , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/cirurgia , Feminino , Humanos , Lactente , Recém-Nascido , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/cirurgia , Masculino , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/cirurgia , Resultado do Tratamento
10.
Int J Pediatr Otorhinolaryngol ; 127: 109682, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31546061

RESUMO

OBJECTIVE: To review a single-surgeon, 16-year experience with the management of infected preauricular sinuses/cysts. METHODS: Computerized search of all office notes and operative reports during the years 2002-2018. SETTING: Academic medical center and suburban office practice. PARTICIPANTS: Children from 0 to 18 years of age with symptomatic preauricular sinuses/cysts. INTERVENTION: Children with symptomatic preauricular sinuses/cysts underwent surgical excision. Those presenting with infected cysts were treated with oral antibiotics, needle-aspiration and/or incision and drainage to control infection prior to surgery. The chronic preauricular abscesses were curetted without resection of overlying skin or the abscess walls. MAIN OUTCOME MEASURE: Control of infection without recurrence following surgery. RESULTS: 415 patient encounters involved preauricular sinuses/cysts. These ultimately led to 56 surgical excisions. 28 of the sinuses/cysts were infected at presentation. All infected lesions were treated with oral antibiotics. 6 infected sinuses/cysts were needle aspirated. 2 infected sinuses/cysts required incision and drainage. 1 infected sinus/cyst could not be controlled by either drainage technique and was surgically excised while actively infected. Nine children presented with chronic preauricular abscesses. One the 28 infected sinuses/cysts (3.5%) recurred 10 years after surgery- it was cured with re-resection at the root of the helix. CONCLUSION: Treatment of infected preauricular sinuses/cysts remains controversial. Control of infection prior to definitive surgery is desirable, but not mandatory. Chronic preauricular abscesses can be managed by sinus/cyst excision and subcutaneous abscess curettage without resection of the abscess wall or overlying skin. This leads to consistent control and favorable cosmesis.


Assuntos
Abscesso/tratamento farmacológico , Abscesso/cirurgia , Anormalidades Craniofaciais/cirurgia , Cistos/cirurgia , Abscesso/complicações , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Anormalidades Craniofaciais/complicações , Cistos/complicações , Drenagem , Humanos , Lactente , Recém-Nascido , Recidiva
11.
BMJ Case Rep ; 12(9)2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31494585

RESUMO

Infections of proximal aortic vascular grafts are a catastrophic complication of aortic surgery. Despite aggressive antimicrobial and surgical intervention, mortality and reinfection rates remain significant. Here, we describe a man aged 71 years with a medical history of bioprosthetic aortic valve with aortic arch replacement (modified Bentall's procedure), who developed a large periprosthetic abscess due to Staphylococcus aureus 7 years after his initial surgery. The patient's preference was to avoid redo surgery, however despite high-dose intravenous flucloxacillin and oral rifampicin therapy, there was rapid progression of the abscess, necessitating urgent surgery. Notwithstanding the burden of infection, the patient underwent successful surgical excision and graft re-implantation and remains independent and well, almost 2 years postoperatively.


Assuntos
Abscesso/microbiologia , Insuficiência da Valva Aórtica/microbiologia , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Abscesso/fisiopatologia , Abscesso/cirurgia , Idoso , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/cirurgia , Procedimentos Cirúrgicos Cardíacos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Masculino , Infecções Relacionadas à Prótese/fisiopatologia , Infecções Relacionadas à Prótese/cirurgia , Reoperação , Fatores de Tempo , Resultado do Tratamento
13.
Georgian Med News ; (292-293): 65-68, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31560665

RESUMO

Infection of the mediastinum is typically polymicrobial in nature resulting from a disruption of normal mucosal and tissue barriers. Infection may result from a rupture of the esophagus or trachea or from surgical intervention. Medaistinal abscess is the most lethal form of mediastinitis. A case report is presented: sepsis - induced polyorganic insufficiency with underlying severe somatic pathological condition and violation of hemodynamics. Clinically the insufficiency of all the organic systems developed at the background of cardio-respiratory-cerebral insufficiency, with functional insufficiency of all the organ systems and violation of buffer system. With reasonable pathognomic and symptomatic treatment eradication of vicious circle was possible. The patient was discharged from the clinic with positive clinical-laboratory recovery. The condition was stable. Neurological status -contacted, adequate, with high capacity to work. The fistula on the anterior wall of the trachea as well as stoma were removed.


Assuntos
Abscesso , Mediastinite/diagnóstico , Mediastino/patologia , Sepse/diagnóstico , Choque Séptico/diagnóstico , Abscesso/patologia , Abscesso/cirurgia , Humanos
14.
Eur Arch Otorhinolaryngol ; 276(11): 3051-3056, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31456037

RESUMO

PURPOSE: To evaluate the clinical course of children with acute mastoiditis (AM) who required surgical intervention. MATERIAL AND METHODS: Clinical and biochemical characteristics at the moment of hospital admission were reviewed for patients who required surgery for AM. Children who were successfully managed conservatively during the last 3 years of study were chosen as a comparison group. RESULTS: During 2008-2017, 570 children were admitted with AM: 82(14%) underwent cortical mastoidectomy, including 31(38%) with decompression of epidural space and sigmoid sinus. The comparison group consisted of 167 children with AM who did not require surgery. The surgical group had a higher rate of acute otitis media before admission. At the time of hospital admission, the surgical group had a higher rate of prolonged fever, otorrhea, and sub-periosteal abscess. Their average temperature, WBC, neutrophil count, and CRP were significantly higher (39.2 vs. 37.9°. C, 20 K vs. 16.5 K, 67 vs. 55.8 percent, 17 vs. 8.8, respectively, p = 0.0001). Fusobacterium necrophorum was the most common pathogen in the surgical group (50%), and group A streptococcus in the comparison group (22%). Sub-periosteal abscess, sinus venous thrombosis, and epidural involvement were diagnosed in 95, 35, and 38 percent of patients, respectively. Average length of IV antibiotic treatment was 20 days in operated children, compared to 5.6 days in the comparison group (p = 0.0001). Since 2013, a significantly higher percentage of children were diagnosed with Fusobacterium mastoiditis (p = 0.0001) who required surgery (p = 0.008). CONCLUSION: In children with AM presenting with, high fever, leukocytosis, elevated CRP, and sub-periosteal abscess, early CT and surgical intervention were frequently required. The increase in Fusobacterium infection might be an explanation for the increase in complicated AM requiring surgery.


Assuntos
Abscesso , Infecções por Fusobacterium , Fusobacterium necrophorum/isolamento & purificação , Mastoidectomia , Mastoidite , Complicações Pós-Operatórias , Abscesso/diagnóstico , Abscesso/microbiologia , Abscesso/cirurgia , Doença Aguda , Pré-Escolar , Tratamento Conservador/métodos , Descompressão Cirúrgica/métodos , Feminino , Infecções por Fusobacterium/fisiopatologia , Infecções por Fusobacterium/cirurgia , Humanos , Lactente , Israel , Masculino , Mastoidectomia/efeitos adversos , Mastoidectomia/métodos , Mastoidite/diagnóstico , Mastoidite/microbiologia , Mastoidite/fisiopatologia , Mastoidite/cirurgia , Seleção de Pacientes , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/microbiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
15.
BMJ Case Rep ; 12(8)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466967

RESUMO

Rothia aeria is a gram-positive amorphous bacillus and was discovered in the Russian space station 'Mir' in 1997. It shows phylogenetic similarity to Actinomyces israelii, and as determined using 16 s ribosomal RNA gene analysis R. aeria is classified as a bacteria of the genus Actinomyces It was found to colonise in the human oral cavity, and there are some infectious reports but none specifies gynaecological infection. A 57-year-old woman, who had been continuously using intrauterine contraceptive device, presented with fever and lower abdominal pain. She was suspected tube-ovarian abscess caused by A. israelii, but the uterine cavity culture revealed R. aeria infection. Considering surgical treatment, conservative treatment by intravenous benzylpenicillin and subsequently oral ampicillin for 6 months improved the abscess, and she has no recurrence for over 1 year.


Assuntos
Abscesso/tratamento farmacológico , Micrococcaceae/isolamento & purificação , Doenças Ovarianas/microbiologia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Abscesso/cirurgia , Actinomyces , Administração Intravenosa , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Feminino , Febre/diagnóstico , Febre/etiologia , Humanos , Dispositivos Intrauterinos/efeitos adversos , Pessoa de Meia-Idade , Penicilina G/administração & dosagem , Penicilina G/uso terapêutico , Resultado do Tratamento
16.
A A Pract ; 13(7): 281-283, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31385818

RESUMO

Postsurgical trigeminal neuralgia (TN), although rare, can lead to significant hemodynamic perturbations by triggering the trigeminocardiac reflex (TCR). The combination can lead to diagnostic as well as management challenges for clinicians. We present the case of a patient with a parotid abscess, which developed as a complication of his otolaryngologic surgery, and which led to repeated episodes of symptomatic bradycardia associated with cardiovascular collapse. This case highlights the importance of heightened awareness, early diagnosis, and timely treatment of postsurgical neuropathic pain syndromes to avoid life-threatening complications.


Assuntos
Bradicardia/etiologia , Neuralgia do Trigêmeo/diagnóstico , Abscesso/cirurgia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Parotídeas/cirurgia , Complicações Pós-Operatórias , Reflexo Trigêmino-Cardíaco , Neuralgia do Trigêmeo/etiologia
17.
World Neurosurg ; 131: 133-136, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31400523

RESUMO

BACKGROUND: Primary, spontaneous, or de novo subgaleal abscesses represent extremely rare lesions usually related to patients with risk factors and predisposing conditions for infections. They are associated with high morbidity, and a proper diagnosis can be misleading. To the best of our knowledge, this is the first reported case of a de novo subgaleal abscess not related to previous traumatic head injury and associated with lung adenocarcinoma. CASE DESCRIPTION: A 59-year-old man was admitted to our unit because he presented fever and a palpable subcutaneous right parietal mass. No history of traumatic head injury was mentioned. The patient underwent needle aspiration of the subgaleal lesion for microbiological, histological, and cytological examination, with negative response. Chest radiograph and then thoracic computed tomography scan revealed the presence of 2 lesions in the left lung. Complete removal with surgical debridement of the parietal bone lesion was performed due to the suspicion of an abscessualized skull metastasis from a primary lung adenocarcinoma. CONCLUSIONS: We strongly suggest a patient global assessment in the event of subgaleal abscess without history of traumatic head injury, to treat eventual associated findings as soon as possible.


Assuntos
Abscesso/complicações , Abscesso/diagnóstico , Adenocarcinoma de Pulmão/complicações , Neoplasias Pulmonares/complicações , Abscesso/patologia , Abscesso/cirurgia , Adenocarcinoma de Pulmão/diagnóstico , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Osso Parietal , Couro Cabeludo
18.
J Laryngol Otol ; 133(8): 662-667, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31267884

RESUMO

BACKGROUND: Retraction pocket theory is the most acceptable theory for cholesteatoma formation. Canal wall down mastoidectomy is widely performed for cholesteatoma removal. Post-operatively, each patient with canal wall down mastoidectomy has an exteriorised mastoid cavity, exteriorised attic, neo-tympanic membrane and shallow neo-middle ear. OBJECTIVE: This study aimed to clinically assess the status of the neo-tympanic membrane and the exteriorised attic following canal wall down mastoidectomy. METHODS: All post canal wall down mastoidectomy patients were recruited and otoendoscopy was performed to assess the neo-tympanic membrane. A clinical classification of the overall status of middle-ear aeration following canal wall down mastoidectomy was formulated. RESULTS: Twenty-five ears were included in the study. Ninety-two per cent of cases showed some degree of neo-tympanic membrane retraction, ranging from mild to very severe. CONCLUSION: After more than six months following canal wall down mastoidectomy, the degree of retracted neo-tympanic membranes and exteriorised attics was significant. Eustachian tube dysfunction leading to negative middle-ear aeration was present even after the canal wall down procedure. However, there was no development of cholesteatoma, despite persistent retraction.


Assuntos
Abscesso/cirurgia , Colesteatoma da Orelha Média/cirurgia , Mastoidectomia/métodos , Mastoidite/cirurgia , Otite Média/complicações , Abscesso/etiologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
19.
Int Heart J ; 60(4): 986-989, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31308324

RESUMO

So far, there is still controversy regarding the optimal prosthetic valve for patients with active infective valve endocarditis with annular abscess. Here, we report the case of a 65-year-old woman who was diagnosed with infective endocarditis associated with extensive annular abscess. The patient underwent debridement of the abscess cavity followed by aortic valve replacement using a Solo Smart (SS) stentless bioprosthesis. Postoperative recovery was uneventful, with no signs of recurrent infection. Since the SS valve is designed for supra-annular and subcoronary implantation, it is considered to be an alternative to conventional prosthetic valves in patients with infective endocarditis with aortic annular abscess.


Assuntos
Abscesso/cirurgia , Valva Aórtica/cirurgia , Bioprótese , Endocardite/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Infecções Estreptocócicas/cirurgia , Abscesso/diagnóstico , Abscesso/microbiologia , Idoso , Valva Aórtica/microbiologia , Endocardite/diagnóstico , Feminino , Próteses Valvulares Cardíacas , Humanos , Desenho de Prótese , Infecções Estreptocócicas/diagnóstico , Streptococcus/isolamento & purificação
20.
BMJ Case Rep ; 12(7)2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31315845

RESUMO

Pott's puffy tumour (PPT) is a known complication of frontal sinusitis. It is defined as subperiosteal abscess formation due to osteomyelitis of the frontal bone presenting as a forehead swelling. It is a life-threatening condition that can lead to intracranial and intraorbital complications. Gadolinium-enhanced MRI and contrast CT scan are the best modalities to localise and define the collection, in addition to confirming disease extension. Once confirmed by imaging and depending on disease extension, management of PPT requires a multidisciplinary team approach and depends on the local provision of surgical care. Following surgical drainage of the abscess cavity, a prolonged course of antibiotics is required postoperatively to treat the underlying osteomyelitis.


Assuntos
Abscesso/tratamento farmacológico , Osso Frontal/patologia , Tumor de Pott/complicações , Abscesso/cirurgia , Administração Intravenosa , Adolescente , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Sinusite Frontal/diagnóstico por imagem , Sinusite Frontal/microbiologia , Sinusite Frontal/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Celulite Orbitária/etiologia , Celulite Orbitária/patologia , Osteomielite/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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