Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.049
Filtrar
3.
J Fr Ophtalmol ; 43(10): e375-e377, 2020 Dec.
Artigo em Francês | MEDLINE | ID: mdl-33121794
4.
Clin Nucl Med ; 45(11): 929-930, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32969906

RESUMO

Ga-prostate-specific membrane antigen (PSMA) PET/CT for primary staging of high-risk prostate cancer revealed increased Ga-PSMA uptake in a known periappendicular abscess in a patient, who had undergone surgical drainage of the abscess 1 month earlier. The case presents another example of Ga-PSMA uptake in a benign infectious and inflammatory condition.


Assuntos
Abscesso/metabolismo , Glicoproteínas de Membrana/metabolismo , Compostos Organometálicos/metabolismo , Abscesso/complicações , Abscesso/diagnóstico por imagem , Idoso , Transporte Biológico , Humanos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/complicações , Neoplasias da Próstata/diagnóstico por imagem
5.
PLoS One ; 15(7): e0235350, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32663203

RESUMO

BACKGROUND: Skin and soft tissue infections (SSTI) are a common but preventable cause of morbidity and mortality among people who inject drugs (PWID). They can be severe, and hospitalisations of PWID with SSTI are rising. The most common SSTI presentations are abscesses and cellulitis. METHODS: We used data from Care & Prevent, a cross-sectional community survey of PWID in London. We reported the lifetime prevalence of SSTI, severity of infections, key risk factors, and associated sequelae. Pictorial questions were used to assess SSTI severity. RESULTS: We recruited 455 PWID. SSTI lifetime prevalence was high: 64% reported an abscess and/or cellulitis. Over one-third (37%) reported a severe infection, 137 (47%) reported hospitalisation. SSTIrisk factors were: aged 35+ years, injecting once or more times a day, subcutaneous or intra-muscular injections, and making four or more attempts to achieve an injection. Those who reported having other health conditions were at higher odds of having an abscess or cellulitis, with risk tending to increase with number of reported conditions. Half (46%) employed self-care for their worst SSTI, and 43% waited for ten or more days before seeking medical care or not seeking medical care at all. CONCLUSIONS: Abscess and cellulitis are very common among PWID in London. We corroborate findings indicating SSTIs are associated with risks, e.g. venous access problems, as well as other co-morbid conditions: septicaemia, endocarditis, DVT, and kidney disease. These co-morbidities may impact SSTIs severity and outcomes. Delayed healthcare seeking potentially exacerbates infection severity, which in turn increases poorer health outcomes and complications.


Assuntos
Abscesso/epidemiologia , Celulite (Flegmão)/epidemiologia , Dermatopatias Infecciosas/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abscesso/complicações , Abscesso/fisiopatologia , Adulto , Celulite (Flegmão)/complicações , Celulite (Flegmão)/fisiopatologia , Feminino , Humanos , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Prevalência , Fatores de Risco , Sepse/complicações , Sepse/epidemiologia , Sepse/fisiopatologia , Dermatopatias Infecciosas/complicações , Dermatopatias Infecciosas/fisiopatologia , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/fisiopatologia , Reino Unido/epidemiologia
6.
Ned Tijdschr Geneeskd ; 1642020 06 30.
Artigo em Holandês | MEDLINE | ID: mdl-32608925

RESUMO

A 12-year-old boy was referred by the general practitioner with a 3-week history of pain in the popliteal fossa. There was no sign of trauma or infection, physical examination was normal, and his CRP level was mildly elevated. X-ray and MRI revealed a Brodie's abscess, which was treated surgically and with antibiotics and he made a good recovery.


Assuntos
Abscesso/diagnóstico , Dor Musculoesquelética/diagnóstico , Osteomielite/diagnóstico , Abscesso/complicações , Abscesso/terapia , Antibacterianos/uso terapêutico , Criança , Diagnóstico Diferencial , Humanos , Imagem por Ressonância Magnética , Masculino , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/terapia , Procedimentos Ortopédicos , Osteomielite/complicações , Osteomielite/terapia , Radiografia
8.
World Neurosurg ; 142: 108-111, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32599191

RESUMO

BACKGROUND: Acute appendicitis is a common abdominal emergency, while cerebral venous sinus thrombosis (CVST) is a rare cerebral vascular disease. Cases of CVST in patients with appendicitis have not been reported in the literature. We present a case of CVST in a patient with appendicular abscess. CASE DESCRIPTION: A 56-year old man presented to our department with a headache for 6 days; he had a history of abdominal pain 15 days before admission. Abdominal contrast-enhanced computed tomography revealed appendicular abscess. Head magnetic resonance venography and contrast-enhanced magnetic resonance imaging showed thrombosis in the left transverse and sigmoid sinus. Antithrombotic treatments were administered, and antibiotic treatments and puncture and drainage were used to treat the appendicular abscess. The patient's headache disappeared after 10 days of treatment, and he had recovered well clinically at 3-month follow-up. CONCLUSIONS: CVST after acute appendicitis is rare, and clinicians should be aware of this complication when suspicious symptoms occur. The underlying mechanisms require further investigation.


Assuntos
Abscesso/complicações , Abscesso/diagnóstico por imagem , Apendicite/complicações , Apendicite/diagnóstico por imagem , Trombose dos Seios Intracranianos/diagnóstico por imagem , Trombose dos Seios Intracranianos/etiologia , Abscesso/terapia , Antibacterianos/administração & dosagem , Apendicite/terapia , Drenagem/métodos , Fibrinolíticos/administração & dosagem , Cefaleia/diagnóstico por imagem , Cefaleia/etiologia , Cefaleia/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Trombose dos Seios Intracranianos/terapia
9.
BMC Infect Dis ; 20(1): 342, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404129

RESUMO

BACKGROUND: Purulent pericarditis is an infectious disease, frequently caused by gram-positive bacteria, that is rarely observed in healthy individuals, and is often associated with predisposing conditions. CASE PRESENTATION: Here, we present the case of an Escherichia coli post-surgical localized purulent pericarditis complicated by transient constrictive pericarditis and its diagnostic and therapeutic management. CONCLUSIONS: Our case report focuses on the importance of imaging-guided treatment of purulent pericardial diseases, in particular on the emerging role of 18 F-labelled 2-fluoro-2-deoxy-D-glucose Positron Emission Tomography/Computed Tomography in pericardial diseases and on the management of transient constrictive pericarditis, often seen after thoracic surgery.


Assuntos
Abscesso/complicações , Estenose da Valva Aórtica/cirurgia , Infecções por Escherichia coli/complicações , Escherichia coli/isolamento & purificação , Pericardite Constritiva/diagnóstico por imagem , Pericardite Constritiva/microbiologia , Infecções Relacionadas à Prótese/complicações , Abscesso/tratamento farmacológico , Antibacterianos/uso terapêutico , Colchicina/uso terapêutico , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Fluordesoxiglucose F18 , Seguimentos , Supressores da Gota/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Pericardite Constritiva/tratamento farmacológico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Infecções Relacionadas à Prótese/microbiologia , Resultado do Tratamento
11.
Am J Med ; 133(11): 1343-1349, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32445720

RESUMO

BACKGROUND: Patients who present to the hospital for infectious complications of intravenous opioid use are at high risk for against-medical-advice discharge and readmissions. The role of medication-assisted treatment for inpatients is not clear. We aimed to assess outcomes prior to and after rollout of an inpatient buprenorphine-based opioid use disorder protocol, as well as to assess outcomes in general for medication-assisted therapy. METHODS: This was a retrospective observational cohort study at our community hospital in New Hampshire. The medical record was searched for inpatients with a complication of intravenous opioid use. We searched for admissions 11 months prior to and after the November 2018 buprenorphine protocol rollout. RESULTS: Rates of medication-assisted therapy usage and buprenorphine linkage increased significantly after protocol rollout. Rates of against-medical-advice discharge did not decrease after protocol rollout, nor did readmissions. However, when evaluating the entire group of patients regardless of date of presentation or protocol use, against-medical-advice discharge rates were substantially lower for patients receiving medication-assisted therapy compared with those receiving supportive care only (30.0% vs 59.6%). Readmissions rates were lower for patients who were discharged with any form of ongoing medication-assisted therapy compared with those who were not (30-day all-cause readmissions 18.8% vs 35.1%; 30-day opioid-related readmissions 10.1% vs 29.9%; 90-day all-cause readmissions 27.3% vs 42.7%; 90-day opioid-related readmissions 15.1% vs 33.3%). CONCLUSIONS: There is a strong association between medication-assisted therapy and reduced against-medical-advice discharge rates. Additionally, maintenance medication-assisted therapy at time of discharge is strongly associated with reduced readmissions rates.


Assuntos
Combinação Buprenorfina e Naloxona/uso terapêutico , Hospitalização , Infecções/terapia , Antagonistas de Entorpecentes/uso terapêutico , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Readmissão do Paciente/estatística & dados numéricos , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Abscesso/complicações , Abscesso/terapia , Doença Aguda , Adulto , Artrite Infecciosa/complicações , Artrite Infecciosa/terapia , Bacteriemia/complicações , Bacteriemia/terapia , Celulite (Flegmão)/complicações , Celulite (Flegmão)/terapia , Estudos de Coortes , Discite/complicações , Discite/terapia , Endocardite/complicações , Endocardite/terapia , Feminino , Infecções por HIV/complicações , Infecções por HIV/terapia , Hepatite C/complicações , Hepatite C/terapia , Humanos , Infecções/complicações , Masculino , Miosite/complicações , Miosite/terapia , Transtornos Relacionados ao Uso de Opioides/complicações , Osteomielite/complicações , Osteomielite/terapia , Alta do Paciente/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/tratamento farmacológico
12.
Int J Pediatr Otorhinolaryngol ; 135: 110086, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32408013

RESUMO

INTRODUCTION: It is unknown the optimal extent of sinus surgery in pediatric patients with orbital cellulitis. Our aim was to determine the nationwide incidence of sinus procedures used to treat pediatric orbital cellulitis. Additionally, we sought to identify patient-factors that influence a multi-procedural approach. METHODS: Cross-sectional analysis of 15,260 cases of primary pediatric orbital cellulitis identified in the Kids' Inpatient Database (KID) from January 1, 2003 to December 31, 2012. Cases were included if they contained a primary diagnosis code of orbital cellulitis. Frequency of sinus procedures in relation to pediatric age cohort were noted (≤8 years versus 9-20 years). Comorbidities, cost, and length-of-stay were compared between age cohorts. Multivariate models investigated patient-factors associated with multiple sinus procedures and patient-factors that affected hospital costs and length-of-stay. RESULTS: Children ≤8 years of age constituted 67% of cases (n = 10,290). 1103 cases (7.2%) were treated with at least one defined sinus procedure; and, 712 of these cases documented more than one sinus procedure. The younger cohort (≤8 years) exhibited fewer sinus procedures and a lower rate of reoperation (4.6% vs 12.8%, p < .001; 5.1% vs 7.7%, p < .001, respectively). Presence of cellulitis/abscess of the face was the strongest predictor of multiple sinus procedures (OR = 1.982, p = .033). Patients with acute sinusitis and those >8 years had similarly increased odds of a multi-procedural approach (OR = 1.333, p = .049; OR = 1.367, p = .032, respectively). Multivariate analysis of cost and length-of-stay found that patients >8 years incurred 14% longer hospital stays and an increase in costs of 9% compared to younger patients (p = .001, p = .039; respectively). The secondary diagnosis with the largest effect on length-of-stay and cost was an intracranical abscess (OR = 2.352, p < .001; OR = 2.752, p < .001; respectively). CONCLUSION: In a nationwide population of pediatric patients with primary orbital cellulitis there was an incidence of sinus surgery in 7.2% of cases - with patients over 8 years having a 2.8-fold increase compared to younger patients. Additionally, nearly two-thirds of patients treated with sinus surgery had multiple sinus procedures. The high incidence of multiple sinus procedures suggests that further prospective studies are needed to elucidate the extent of drainage associated with the best patient outcomes.


Assuntos
Abscesso/cirurgia , Celulite Orbitária/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Sinusite/cirurgia , Abscesso/complicações , Doença Aguda , Adolescente , Fatores Etários , Criança , Pré-Escolar , Doença Crônica , Estudos de Coortes , Estudos Transversais , Drenagem/efeitos adversos , Feminino , Custos Hospitalares , Humanos , Lactente , Pacientes Internados , Tempo de Internação , Masculino , Celulite Orbitária/etiologia , Estudos Prospectivos , Estudos Retrospectivos , Sinusite/complicações
13.
Intern Med ; 59(16): 2067-2070, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32389944

RESUMO

Odontogenic infections, generally caused by dental caries and periodontal disease, can result in fatal illness. We herein report a 71-year-old Japanese woman with type 2 diabetes and hemodialysis who suffered from multiple dentofacial abscesses mainly caused by multidrug-resistant Streptococcus oralis. She complained of pain and swelling of her face, with an extraoral fistula from the left cheek. Following 3 surgical debridement procedures and partial mandibulectomy, in addition to 12 weeks of antimicrobial therapy, the multiple dentofacial abscesses were ameliorated. A combination of surgical and antimicrobial treatments following an early diagnosis is essential for reducing further complications.


Assuntos
Abscesso/complicações , Abscesso/microbiologia , Diabetes Mellitus Tipo 2/complicações , Diálise Renal , Infecções Estreptocócicas/complicações , Idoso , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Infecções Estreptocócicas/terapia , Streptococcus oralis
14.
Pan Afr Med J ; 35: 18, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32341739

RESUMO

Introduction: This pilot study aimed to document our results of treating anorectal abscesses with drainage plus loose seton for possible coexisting high fistulas or drainage plus fistulotomy for low tracts at the same operation. Methods: Drainage plus fistulotomy were performed only in cases with subcutaneous mucosa, intersphincteric, or apparently low transsphincteric fistula tracts. For all other cases with high transsphincteric fistula or those with questionable sphincter involvement, a loose seton was placed through the tract. Drainage only was carried out in 17 patients. Results: Twenty-three patients underwent drainage plus loose seton. Drainage plus fistulotomy were performed in four cases. None of the patients developed recurrent abscess during a follow-up of 12 months. Not surprisingly, the incontinence scores were similar pre and post-operatively (p=0.564). Only minor complications occurred in 4 cases (14.8 percent). Secondary interventions following loose seton were carried out in 13 patients (48.1 percent). At 12 months, drainage only was followed by 10 recurrences (58.8 percent; p<0.0001, compared with concomitant surgery). Conclusion: Concomitant loose seton treatment of high fistula tracts associated with anorectal abscess prevents abscess recurrence without significant complications or disturbance of continence. Concomitant fistulotomy for associated low fistulas also aids in the same clinical outcome. Concomitant fistula treatment with the loose seton may suffice in treating the whole disease process in selected cases. Even in patients with high fistula tracts, the loose seton makes fistula surgery simpler with a mature tract. Abscess recurrence is high after drainage only.


Assuntos
Abscesso/cirurgia , Doenças do Ânus/cirurgia , Drenagem , Complicações Pós-Operatórias/prevenção & controle , Doenças Retais/cirurgia , Abscesso/complicações , Adulto , Doenças do Ânus/complicações , Doenças do Ânus/patologia , Procedimentos Cirúrgicos do Sistema Digestório/instrumentação , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Drenagem/efeitos adversos , Drenagem/instrumentação , Drenagem/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Doenças Retais/complicações , Doenças Retais/patologia , Fístula Retal/complicações , Fístula Retal/patologia , Fístula Retal/cirurgia , Recidiva , Prevenção Secundária/instrumentação , Prevenção Secundária/métodos , Resultado do Tratamento
15.
Clin Imaging ; 63: 24-29, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32120309

RESUMO

A horseshoe abscess is caused by infection that spreads between the flexor tendon sheath of the thumb or little finger through the radial and ulnar bursae through communication between the two and/or the space of Parona. We present a case of an 80-year-old woman with rheumatoid arthritis who presented with 6 months of right hand and wrist soft tissue swelling, initially treated as a rheumatoid arthritis flare. MRI demonstrates the horseshoe abscess and after surgical irrigation and debridement with synovectomy, cultures demonstrated infection with mycobacterium avium intracellulare (MAI). This case demonstrates the importance of MRI in diagnosing and evaluating the extent of hand infections and for considering mycobacterial organisms for appropriate treatment and antibiotic regimen.


Assuntos
Abscesso/diagnóstico por imagem , Mãos/diagnóstico por imagem , Infecção por Mycobacterium avium-intracellulare/diagnóstico por imagem , Abscesso/complicações , Idoso de 80 Anos ou mais , Antibacterianos , Artrite Reumatoide/complicações , Feminino , Humanos , Tenossinovite , Punho , Articulação do Punho
17.
J Med Case Rep ; 14(1): 10, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31941541

RESUMO

BACKGROUND: Thrombosis of the internal jugular vein occasionally occurs in association with long-term placement of a central venous catheter; however, such complications rarely involve calcification within the blood vessels. We report a case of calcification and abscess formation around a central venous catheter tip. CASE PRESENTATION: Our patient was an 84-year-old Asian woman who developed a fever that had started approximately 5 months after the placement of a central venous catheter. At the time of presentation, blood tests showed a marked inflammatory response, and chest computed tomography showed a high absorption area and air density around the catheter tip. Therefore, the patient was diagnosed with abnormal intravascular calcification and a deep neck abscess associated with long-term central venous catheter placement. The initial plan was to administer antibiotics and remove the central venous catheter. However, central venous catheter removal was deemed difficult due to the calcification and therefore required an incision. Because of the patient's advanced age and dementia, her family requested antibiotic treatment only. Following antibiotic treatment, the patient's inflammatory response normalized, and her fever resolved. The treatment was discontinued, and the patient's condition gradually stabilized. CONCLUSIONS: Catheter-related complications of central venous catheter placement include vascular occlusion, extravasation of the infusion, and infection. However, abnormal calcification in the blood vessels is extremely rare, and there has been only one case report of a neonate with central venous catheter-related vascular calcification in Japan. The etiology of intravascular calcification is considered to be related to the infusion content and the infusion rate of high caloric infusions and blood products. The incidence of complications associated with long-term central venous catheter placement is expected to increase with the increasing aging of the population and advances in chemotherapy. The report of the clinical course of this rare case adds to the body of knowledge in this area.


Assuntos
Abscesso/complicações , Calcinose/complicações , Infecções Relacionadas a Cateter/complicações , Cateteres de Demora/efeitos adversos , Cateteres Venosos Centrais/efeitos adversos , Doenças Vasculares/complicações , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Feminino , Humanos , Japão/epidemiologia
19.
J Craniofac Surg ; 31(4): e324-e326, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31895864

RESUMO

Carotid artery pseudoaneurysm are a rare complication of deep neck infections, especially in the antibiotic era. Although it is rare, it may result in life-threatening conditions. Here, the authors present a case of pseudoaneurysm of the carotid artery caused by parapharyngeal abscess and causing massive oropharyngeal bleeding and treat with endovascular approach in a 40-year-old woman presenting with neck swelling and fever.


Assuntos
Abscesso/cirurgia , Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Primitiva/cirurgia , Hemorragia/cirurgia , Doenças Faríngeas/cirurgia , Abscesso/complicações , Adulto , Lesões das Artérias Carótidas/etiologia , Procedimentos Endovasculares , Feminino , Hemorragia/etiologia , Humanos , Doenças Faríngeas/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA