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1.
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
2.
Hinyokika Kiyo ; 66(9): 323-326, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32988171

RESUMO

An 82-year-old man visited our department with a chief complaint of penile pain and swelling. He was receiving maintenance dialysis for chronic renal failure and was catheterized because of urinary retention associated with prostatic hypertrophy. The penis was reddened with swelling extending to the root and marked tenderness. Blood tests indicated inflammation and imaging revealed an abscess with emphysematous changes in the cavernous region of the penis. The diagnosis was purulent penile cavernitis. His symptoms improved after decompression with incision and drainage. There has been no recurrence of the abscess in the 4 months since treatment.


Assuntos
Enfisema , Hiperplasia Prostática , Retenção Urinária , Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Idoso de 80 Anos ou mais , Humanos , Masculino , Pênis
4.
Praxis (Bern 1994) ; 109(8): 615-630, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-32517600

RESUMO

Contrast-Enhanced Ultrasound as a Diagnostic Tool in Diseases of the Digestive Tract Abstract. Contrast-enhanced ultrasound is a good diagnostic tool in certain gastrointestinal diseases. Inflammation of the gastric and the bowel wall can often be distinguished from neoplastic alterations. Gastric and duodenal stenosis can be depicted with the use of oral contrast, and after stenting the patency can be documented. Abscesses are perfectly delineated, and after drainage the exact location of the tube and possible complications can be documented. In patients with Crohn's disease inflammatory activity and complications such as abscesses, fistulas and stenotic areas can be depicted. Distinction of fibrotic from inflammatory stenosis may help to look for surgical intervention in due time. Acute ischemic colitis has a typical perfusion pattern, and a control after a few days may show an increased vascularity.


Assuntos
Doença de Crohn , Ultrassonografia , Abscesso/diagnóstico por imagem , Meios de Contraste , Doença de Crohn/diagnóstico por imagem , Fibrose , Humanos
7.
J Craniofac Surg ; 31(4): 1111-1113, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32282484

RESUMO

Penetrating orbital trauma in the pediatric population is rare. Even more unusual is a secondary orbital infection following penetrating trauma. Here we present a highly unusual case of fulminant facial cellulitis with an orbital abscess in an otherwise healthy 3-year-old boy following a penetrating injury to the orbit from a point of entry on the gingiva-buccal sulcus, sustained during a fall while carrying a wooden lollipop stick. Examination of the retina revealed a focal injury at the inferior pole of the globe. The organisms cultured from pus sampled from the abscess and from the discharging intraoral wound revealed the same oral commensals while the MRI revealed a track in continuity with the orbital collection.


Assuntos
Abscesso/etiologia , Doenças da Boca/cirurgia , Doenças Orbitárias/etiologia , Ferimentos Penetrantes/cirurgia , Abscesso/diagnóstico por imagem , Pré-Escolar , Humanos , Masculino , Doenças Orbitárias/diagnóstico por imagem , Tomografia Computadorizada por Raios X
8.
BMJ Case Rep ; 13(4)2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32317364

RESUMO

We describe a case of paediatric orbital cellulitis with subperiosteal abscess following blunt facial trauma. Clinical features of orbital cellulitis developed on day 1 post-trauma. A subperiosteal collection subsequently formed lateral to the globe, causing significant ocular compromise. Surgical drainage and sinus washout were performed via external incisions, with satisfactory outcome. This case highlights how trauma may represent a non-sinogenic aggravating factor in orbital cellulitis. We describe how a subperiosteal abscess may vary depending on its aetiology, and how the surgical approach can be modified to locate and drain a laterally sited subperiosteal abscess.


Assuntos
Abscesso/diagnóstico por imagem , Edema/diagnóstico por imagem , Traumatismos Faciais/complicações , Celulite Orbitária/etiologia , Ferimentos não Penetrantes/complicações , Adolescente , Antibacterianos/uso terapêutico , Drenagem/métodos , Feminino , Humanos , Celulite Orbitária/terapia , Resultado do Tratamento
9.
An. sist. sanit. Navar ; 43(1): 99-102, ene.-abr. 2020. ilus
Artigo em Inglês | IBECS | ID: ibc-193683

RESUMO

Infections of the subscapular space are very infrequent entities, which is why their diagnosis (for which it is crucial to carry out magnetic resonance imaging or, failing that, computerized tomography) can prove complicated. This difficulty in making the diagnosis conditions the speed of treatment (surgical draining that can be accompanied by antibiotherapy), which is crucial for the medium and long-term prognosis. We present the case of a patient who developed a spontaneous subscapular abscess that was drained using a delto-pectoral approach, with the subscapular space accessed via a medial route to the coracoids. The relevance of this case lies in its singular character and in the description of an approach that has only been used in two prior cases in the literature


Las infecciones del espacio subescapular son entidades muy poco frecuentes y, por ello, su diagnóstico (para el que resulta clave la realización de una resonancia magnética o, en su defecto, una tomografía computarizada) puede resultar complicado. Esta dificultad en el diagnóstico condiciona la rapidez en el tratamiento (drenaje quirúrgico acompañado o no de antibioterapia), que resulta clave para el pronóstico a medio y largo plazo. Presentamos el caso de un paciente que desarrolló un absceso subescapular espontáneo que se drenó mediante un abordaje delto-pectoral, accediendo al espacio subescapular por vía medial a la coracoides. La relevancia del caso presentado radica en su singularidad y en la descripción de una vía de abordaje que solo ha sido empleada en dos casos previos en la literatura


Assuntos
Humanos , Masculino , Adulto , Manguito Rotador/diagnóstico por imagem , Manguito Rotador/patologia , Abscesso/cirurgia , Infecções dos Tecidos Moles/cirurgia , Manguito Rotador/cirurgia , Abscesso/diagnóstico por imagem , Infecções dos Tecidos Moles/diagnóstico por imagem , Infecções dos Tecidos Moles/tratamento farmacológico , Espectroscopia de Ressonância Magnética , Infecções dos Tecidos Moles/microbiologia , Cloxacilina/administração & dosagem , Levofloxacino/administração & dosagem
10.
Br J Radiol ; 93(1110): 20200063, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32271626

RESUMO

Multiparametric ultrasound (MPUS), combining conventional techniques (greyscale and colour Doppler ultrasound), ultrasound strain elastography, and contrast-enhanced ultrasound (CEUS), has been successfully used in the assessment of adult scrotal pathology. Contrast-enhanced ultrasound can confidently establish testicular tissue vascularity even in the small-volume paediatric testis. Elastography provides further assessment of tissue stiffness, potentially adding useful diagnostic information. In children, ultrasonography is particularly advantageous, being safe, radiation-free and negating the need for sedation or general anaesthesia during the imaging evaluation. In this review article, we aim to familiarise readers with the MPUS scanning protocol used for paediatric scrotal examination and provide an overview of scrotal MPUS features, with particular focus to clinical indications where MPUS may be advantageous over conventional ultrasonography.


Assuntos
Doenças dos Genitais Masculinos/diagnóstico por imagem , Escroto/diagnóstico por imagem , Ultrassonografia/métodos , Abscesso/diagnóstico por imagem , Adolescente , Fatores Etários , Criança , Contraindicações de Medicamentos , Meios de Contraste/administração & dosagem , Meios de Contraste/efeitos adversos , Cistos/diagnóstico por imagem , Ecocardiografia Doppler em Cores , Técnicas de Imagem por Elasticidade/métodos , Epididimite/diagnóstico por imagem , Humanos , Recém-Nascido , Infarto/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Masculino , Fosfolipídeos/administração & dosagem , Fosfolipídeos/efeitos adversos , Escroto/lesões , Torção do Cordão Espermático/diagnóstico por imagem , Hexafluoreto de Enxofre/administração & dosagem , Hexafluoreto de Enxofre/efeitos adversos , Neoplasias Testiculares/diagnóstico por imagem , Testículo/irrigação sanguínea , Testículo/diagnóstico por imagem , Testículo/lesões
12.
West J Emerg Med ; 21(2): 336-342, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32191191

RESUMO

INTRODUCTION: Skin and soft tissue infections (SSTI) occur along a continuum from cellulitis to abscess. Point-of-care ultrasound (POCUS) is effective in differentiating between these two diagnoses and guiding acute management decisions. Smaller and more superficial abscesses may not require a drainage procedure for cure. The goal of this study was to evaluate the optimal abscess size and depth cut-off for determining when a drainage procedure is necessary. METHODS: We conducted a retrospective study of adult patients with a SSTI who had POCUS performed. Patients were identified through an ultrasound database. We reviewed examinations for the presence, size, and depth of abscess. Medical records were reviewed to determine acute ED management and assess outcomes. The primary outcome evaluated the optimal abscess size and depth when a patient could be safely discharged without a drainage procedure. We defined a treatment failure as a return visit within seven days requiring admission, change in antibiotics, or drainage procedure. RESULTS: A total of 162 patients had an abscess confirmed on POCUS and were discharged from the ED without a drainage procedure. The optimal cut-off to predict treatment failure by receiver operating curve analysis was 1.3 centimeters (cm) in longest dimension with a sensitivity of 85% and specificity of 37% (area under the curve [AUC] 0.60, 95% confidence interval [CI], 0.44-0.76), and 0.4cm in depth with a sensitivity of 85% and specificity of 68% (AUC 0.83, 95% CI, 0.74-93). CONCLUSION: This retrospective data suggests that abscesses greater than 0.4 cm in depth from the skin surface may require a drainage procedure. Those less than 0.4 cm in depth may not require a drainage procedure and may be safely treated with antibiotics alone. Further prospective data is needed to validate these findings and to assess for an optimal size cut-off when a patient with a skin abscess may be discharged without a drainage procedure.


Assuntos
Abscesso , Sistemas Automatizados de Assistência Junto ao Leito , Infecções dos Tecidos Moles , Ultrassonografia , Abscesso/diagnóstico por imagem , Abscesso/terapia , Adulto , Antibacterianos/uso terapêutico , Celulite (Flegmão) , Drenagem/métodos , Feminino , Humanos , Masculino , Registros Médicos , Pessoa de Meia-Idade , Alta do Paciente , Exame Físico , Estudos Retrospectivos , Sensibilidade e Especificidade , Infecções dos Tecidos Moles/diagnóstico por imagem , Infecções dos Tecidos Moles/terapia , Falha de Tratamento , Ultrassonografia/métodos
13.
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
16.
Pediatr Emerg Care ; 36(3): 165-167, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32011555

RESUMO

Point-of-care ultrasound (POCUS) is an integral part of pediatric emergency medicine. One evolving use of POCUS is in the diagnosis and management of skin and soft tissue infections. Point-of-care ultrasound can be used to identify clinically occult infections and can be used to guide percutaneous drainage of both superficial and deep abscesses. Here, we present a case where POCUS- and US-guided needle aspiration had a significant impact on patient care by providing rapid diagnosis, as well as expediting microbiological speciation in a young male presenting with left-sided back and buttock pain.


Assuntos
Abscesso/diagnóstico por imagem , Drenagem/métodos , Serviço Hospitalar de Emergência , Ílio/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Abscesso/cirurgia , Adolescente , Humanos , Masculino , Sistemas Automatizados de Assistência Junto ao Leito , Infecções Estafilocócicas/diagnóstico
18.
Monaldi Arch Chest Dis ; 90(1)2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32072799

RESUMO

Tubercular splenic abscess is rare, particularly in immunocompetent patients. Diagnostic difficulties usually arise in patients with tubercular splenic abscess because of its non-specific presentation. We report an elderly male who presented with cough and fever and had pulmonary infiltrates suspicious of tuberculosis. Bronchoalveolar lavage microbiology including XpertMTB/Rif assay was non-contributory. Contrast enhanced computed tomography scan of abdomen revealed multiple non-enhancing lesions in the spleen. Ultrasound guided splenic aspirate revealed pus that was positive for Mycobacterium tuberculosis in XpertMTB/Rif assay confirming the diagnosis of tuberculosis.


Assuntos
Abscesso/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Esplenopatias/microbiologia , Tuberculose/complicações , Abscesso/diagnóstico por imagem , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Lavagem Broncoalveolar/métodos , Humanos , Imunocompetência/imunologia , Masculino , Paracentese/métodos , Esplenopatias/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Ultrassonografia de Intervenção/métodos
20.
BMC Infect Dis ; 20(1): 133, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32050917

RESUMO

BACKGROUND: Vertebral osteomyelitis can be attributed to many factors including immunosuppression, diabetes, malignancy, collagen disease, periodontal disease, open fractures, and endoscopic procedures. Anaerobic bacteria, such as Veillonella species, are found in the oral cavity and are rarely implicated in the infection. This report describes vertebral osteomyelitis secondary to a dental abscess with positive Veillonella cultures. CASE DESCRIPTION: A 76-year-old man presented to the hospital due to back pain with a four-day history of fever and chills. CT scans revealed several abscesses in the lumbar region as well as indications of vertebral osteomyelitis. After a psoas drain, the patient began antibiotics with a combination of ampicillin-sulbactam, metronidazole, and levofloxacin, but due to the patient's penicillin allergy, he was initially desensitized to this antibiotic for a significant period of time. Laminectomies, foraminotomies, and facetectomies were performed, but the infection spread to vertebral levels. The patient was then switched to a combination of vancomycin, metronidazole, and levofloxacin which eliminated the infection. Final laminectomy was performed with posterior segmental instrumentation and arthrodesis. Post-operatively, there were no signs of infection. The patient recovered well and regained mobility. Deeper examination of the patient's medical history revealed a severe tooth abscess immediately before the onset of bacteremia. CONCLUSION: We believe that a delay in the onset of antibiotic treatment is what led to the initial bacteremia that ultimately took root in the lower lumbar vertebrae. To the best of our ability, we could identify only one other case that linked vertebral osteomyelitis to the oral cavity.


Assuntos
Abscesso/tratamento farmacológico , Bacteriemia/microbiologia , Osteomielite/etiologia , Osteomielite/terapia , Abscesso Periodontal/complicações , Abscesso/diagnóstico por imagem , Idoso , Antibacterianos/uso terapêutico , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/tratamento farmacológico , Bacteriemia/tratamento farmacológico , Bacteriemia/etiologia , Foraminotomia , Humanos , Laminectomia , Vértebras Lombares/microbiologia , Vértebras Lombares/cirurgia , Masculino , Osteomielite/diagnóstico por imagem , Osteomielite/microbiologia , Abscesso Periodontal/microbiologia , Tomografia Computadorizada por Raios X , Veillonella/patogenicidade
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