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1.
Heart Surg Forum ; 24(2): E372-E374, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33891542

RESUMO

The world has suffered over the past year under COVID-19. Unfortunately, people still are getting sick from other, also severe, diseases. Although the COVID-19 infection is present, patients need treatment for other life-threatening conditions. We present the case of a 36-year-old patient with severe infective endocarditis with a large abscess of the aortic root, who also is COVID-19 positive. Definitive diagnostics and treatment were avoided due to COVID-19 infection. In the end, emergent surgery was indicated due to acute cardiac decompensation and the development of heart failure symptoms, and the patient recovered uneventfully after surgery.


Assuntos
Abscesso/microbiologia , Abscesso/cirurgia , Doenças da Aorta/microbiologia , Doenças da Aorta/cirurgia , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/cirurgia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/terapia , Abscesso/diagnóstico por imagem , Adulto , Doenças da Aorta/diagnóstico por imagem , Endocardite Bacteriana/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Masculino , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/microbiologia , Derrame Pleural/cirurgia , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Respiração Artificial
2.
BMC Infect Dis ; 21(1): 196, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607951

RESUMO

BACKGROUND: Non-tuberculous mycobacterial (NTM) infections are increasing worldwide, making them an international public health problem. Surgical management is often indicated for localized infectious disease; however, most surgeons are unaware of the potential risks of transmission during surgery. CASE PRESENTATION: An 88-year-old Asian female was referred to our hospital for a tumor in the right lateral thoracic region. One month prior, she had a feeling of fullness and complained of localized pain and warmth in the right lateral thoracic wall. Pain and warmth gradually resolved without intervention; however, the fullness was getting worse. Computed tomography (CT) scan showed a mass of approximately 65 × 30 mm with an osteolytic change, involving the right 8th rib. Based on the rapid growth rate and CT findings, we strongly suspected a malignant chest wall tumor, and en bloc tumor resection with the 8th rib was performed. When the specimen was cut, a large amount of viscous pus was drained and its culture showed growth of Mycobacterium avium. Microscopically, the non-caseating epithelioid cell granuloma extended into the rib, infiltrating the bone cortex. On follow-up 1 month after discharge, there were no signs of infection or other adverse events associated with the surgery. CONCLUSIONS: Herein, we report about a patient with a mass diagnosed as an NTM abscess involving the rib cage, which was confused with a malignant tumor and eventually diagnosed following surgical excision. This report emphasizes the need to be aware of the possibility of NTM infection and take appropriate precautions if the patient has a rapidly growing mass in the chest wall.


Assuntos
Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/patologia , Parede Torácica/microbiologia , Parede Torácica/patologia , Abscesso/diagnóstico por imagem , Abscesso/microbiologia , Abscesso/patologia , Abscesso/cirurgia , Idoso de 80 Anos ou mais , Drenagem , Feminino , Granuloma/microbiologia , Granuloma/patologia , Granuloma/cirurgia , Humanos , Infecções por Mycobacterium não Tuberculosas/diagnóstico por imagem , Infecções por Mycobacterium não Tuberculosas/cirurgia , Mycobacterium avium/isolamento & purificação , Parede Torácica/diagnóstico por imagem , Parede Torácica/cirurgia , Resultado do Tratamento
3.
Khirurgiia (Mosk) ; (2): 84-87, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33570360

RESUMO

Acute hematogenous osteomyelitis (AHO) in adults is a rare disease complicating timely diagnosis. Even greater difficulties are observed in case of pelvic bone lesion. The authors report AHO of the pelvis an adult. Osteomyelitis was complicated by generalized infection and multiple pyogenic abscesses in subcutaneous adipose tissue of the upper and lower extremities. Detection of primary infectious focus was complicated by extreme severity of the patient's condition and low informative value of X-ray and ultrasound at the early stage of disease. Staphylococcus aureus was obtained from blood culture and infectious foci. Surgical debridement along with complex intensive care ensured a positive outcome.


Assuntos
Abscesso , Osteomielite , Ossos Pélvicos , Infecções Estafilocócicas , Abscesso/diagnóstico , Abscesso/etiologia , Abscesso/microbiologia , Abscesso/terapia , Doença Aguda , Adulto , Antibacterianos/uso terapêutico , Desbridamento , Extremidades/microbiologia , Humanos , Osteomielite/diagnóstico , Osteomielite/etiologia , Osteomielite/microbiologia , Osteomielite/terapia , Ossos Pélvicos/microbiologia , Ossos Pélvicos/cirurgia , Pelve/diagnóstico por imagem , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia , Staphylococcus aureus/isolamento & purificação , Gordura Subcutânea/microbiologia
4.
AJR Am J Roentgenol ; 216(3): 812-823, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33439049

RESUMO

OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. CONCLUSION. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement.


Assuntos
Enfisema/diagnóstico por imagem , Gases , Tomografia Computadorizada por Raios X , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/microbiologia , Abscesso/diagnóstico por imagem , Abscesso/microbiologia , Aortite/diagnóstico por imagem , Aortite/microbiologia , Cistite/diagnóstico por imagem , Cistite/microbiologia , Enfisema/microbiologia , Colecistite Enfisematosa/diagnóstico por imagem , Colecistite Enfisematosa/microbiologia , Feminino , Gangrena de Fournier/diagnóstico por imagem , Gangrena de Fournier/microbiologia , Gangrena Gasosa/diagnóstico por imagem , Gangrena Gasosa/microbiologia , Gastrite/diagnóstico por imagem , Gastrite/microbiologia , Hepatite/diagnóstico por imagem , Hepatite/microbiologia , Humanos , Masculino , Pancreatite/diagnóstico por imagem , Pancreatite/microbiologia , Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/microbiologia , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/microbiologia , Pielite/diagnóstico por imagem , Pielite/microbiologia , Pielonefrite/diagnóstico por imagem , Pielonefrite/microbiologia , Doenças Uterinas/diagnóstico por imagem , Doenças Uterinas/microbiologia
7.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431537

RESUMO

Acute parotitis progressing to parotid abscess is rare in children. Staphylococcus aureus is the usual pathogen in parotid abscess. Granulomatous parotid abscess due to tubercular aetiology is extremely rare. Authors report a case of chronic parotid abscess in a child who received multiple courses of antibiotics without any cure. The ultrasonography and CT scan of the parotid gland confirmed the extent of parotid abscess and the changes in the parotid lymph nodes. The surgical drainage and the biopsy of the lymph nodes lead to the diagnosis of granulomatous abscess. The antitubercular therapy finally cured the disease without further recurrence.


Assuntos
Abscesso/microbiologia , Antituberculosos/uso terapêutico , Parotidite/microbiologia , Tuberculose dos Linfonodos/diagnóstico , Tuberculose Bucal/diagnóstico , Abscesso/diagnóstico , Abscesso/terapia , Biópsia , Criança , Drenagem , Quimioterapia Combinada , Humanos , Linfonodos/patologia , Linfonodos/cirurgia , Masculino , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/microbiologia , Glândula Parótida/patologia , Glândula Parótida/cirurgia , Parotidite/diagnóstico , Parotidite/terapia , Tomografia Computadorizada por Raios X , Teste Tuberculínico , Tuberculose dos Linfonodos/microbiologia , Tuberculose dos Linfonodos/terapia , Tuberculose Bucal/complicações , Tuberculose Bucal/microbiologia , Tuberculose Bucal/terapia , Ultrassonografia
9.
J Surg Res ; 257: 195-202, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32858320

RESUMO

BACKGROUND: Literature on pediatric breast abscesses is sparse; therefore, treatment is based on adult literature which has shifted from incision and drainage (I&D) to needle aspiration. However, children may require different treatment due to different risk factors and the presence of a developing breast bud. We sought to characterize pediatric breast abscesses and compare outcomes. MATERIALS AND METHODS: A retrospective review of patients presenting with a primary breast abscess from January 2008 to December 2018 was conducted. Primary outcome was persistent disease. Antibiotic utilization, treatment required, and risk factors for abscess and recurrence were also assessed. A follow-up survey regarding scarring, deformity, and further procedures was administered. Fisher's exact and Kruskal-Wallis tests for group comparisons and multivariable regression to determine associations with recurrence were performed. RESULTS: Ninety-six patients were included. The median age was 12.8 y [IQR 4.9, 14.3], 81% were women, and 51% were African-American. Most commonly, patients were treated with antibiotics alone (47%), followed by I&D (27%), and aspiration (26%). Twelve patients (13%) had persistent disease. There was no difference in demographic or clinical characteristics between those with persistent disease and those who responded to initial treatment. The success rates of primary treatment were 80% with antibiotics alone, 90% with aspiration, and 96% with I&D (P = 0.35). The median time to follow-up survey was 6.5 y [IQR 4.4, 8.5]. Four patients who underwent I&D initially reported significant scarring. CONCLUSIONS: Treatment modality was not associated with persistent disease. A trial of antibiotics alone may be considered to minimize the risk of breast bud damage and adverse cosmetic outcomes with invasive intervention.


Assuntos
Abscesso/terapia , Antibacterianos/uso terapêutico , Doenças Mamárias/terapia , Drenagem/estatística & dados numéricos , Paracentese/estatística & dados numéricos , Infecções Estafilocócicas/terapia , Abscesso/epidemiologia , Abscesso/microbiologia , Adolescente , Doenças Mamárias/epidemiologia , Doenças Mamárias/microbiologia , Criança , Feminino , Seguimentos , Humanos , Masculino , Recidiva , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus/isolamento & purificação , Resultado do Tratamento
10.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318274

RESUMO

Splenic abscess is a rare entity, however if unrecognised or left untreated, it is invariably fatal. We herein report a case of splenic abscess in a 40-year-old man presenting with fever, left-sided abdominal pain, altered sensorium and vomiting. On clinical examination, hepatosplenomegaly was noted and the ultrasound of the abdomen showed multiple hypoechoic regions in the upper pole of spleen, and the diagnosis of splenic abscess was made. The patient received antimicrobial therapy and underwent an open splenectomy with full recovery. Pus aspirated from the splenic abscess grew an unusual organism named Parabacteroides distasonis In the literature, there are only a few recorded cases of P. distasonis causing splenic abscess. Through this case report, we would like to emphasise the pathogenic role of P. distasonis in causing clinical disease, as this organism is typically known to constitute a part of the normal flora.


Assuntos
Abscesso/microbiologia , Bacteroidetes/patogenicidade , Infecções por Bactérias Gram-Negativas/microbiologia , Esplenopatias/microbiologia , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Adulto , Antibacterianos/uso terapêutico , Quimioterapia Combinada , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/cirurgia , Humanos , Masculino , Esplenectomia , Esplenopatias/tratamento farmacológico , Esplenopatias/cirurgia
11.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318282

RESUMO

This report presents the case of a mixed infection of Actinomyces israelii and Fusobacterium nucleatum, presenting as an extensive neck mass progressing through tissue planes and causing bony destruction. Despite multiple abscess aspirates, imaging and serological investigations, the causative organisms proved elusive over the course of the patient's long admission, only to be identified postdischarge. The patient was successfully initiated on a prolonged course of intravenous antibiotics and did not suffer from any complications. This report aims to raise awareness of the presentation, pathogenicity and treatment of Actinomyces and Fusobacteria infections, given a notable difficulty in diagnosis.


Assuntos
Abscesso/etiologia , Actinomyces/isolamento & purificação , Coinfecção/diagnóstico , Coinfecção/microbiologia , Fusobacterium nucleatum/isolamento & purificação , Pescoço/patologia , Abscesso/microbiologia , Actinomicose/diagnóstico , Actinomicose/microbiologia , Administração Intravenosa , Idoso , Antibacterianos/administração & dosagem , Coinfecção/tratamento farmacológico , Infecções por Fusobacterium/diagnóstico , Infecções por Fusobacterium/microbiologia , Humanos , Masculino , Tomografia Computadorizada por Raios X
12.
Int. j. odontostomatol. (Print) ; 14(4): 586-589, dic. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1134543

RESUMO

ABSTRACT: Our objective was report an extremely rare case of isolated meningitis and suppurative dacrioadenitis as consequences of odontogenic sinusitis. We describe the diagnostic tools including imaging and culture, as well as surgical treatment and follow-up. Our final diagnosis was odontogenic sinusitis caused by Streptococcus Anginosus complicated by isolated meningitis and lacrimal gland abscess. Urgent surgical treatment to restore the paranasal sinuses and drainage of the lacrimal gland was performed. Culture from purulent material collected from maxillary sinus indicated the targeted therapy. Clinical assessment and imaging obtained 20 days after surgery demonstrated successful results. This case emphasizes the importance of evaluating intracranial complications of rinosinusitis, the need to search for a dental infection when a maxillary sinusitis is encountered, the key role of a thorough diagnostic workup in order to plan a comprehensive and effective surgical treatment, as well as targeted medical therapy.


RESUMEN: En este estudio se informa un caso extremadamente raro de meningitis aislada y dacrioadenitis supurativa, como consecuencia de sinusitis odontogénica. Describimos las herramientas de diagnóstico que incluyen imágenes y cultivo, como también el tratamiento quirúrgico y el seguimiento. El diagnóstico final fue de sinusitis odontogénica causada por estreptococo anginoso complicado por una meningitis aislada y el absceso de la glándula lagrimal. Se realizó un tratamiento quirúrgico de urgencia para restaurar los senos paranasales y drenar la glándula lagrimal. Se determinó el tratamiento de acuerdo a los resultados de cultivo del seno maxilar. La evaluación clínica y las imágenes obtenidas 20 días después de la cirugía demostraron resultados exitosos. Es importante la evaluación de las complicaciones intracraneales de la rinosinusitis además de la necesidad de considerar una infección dental frente a una sinusitis maxilar. Por otra parte, es clave una evaluación exhaustiva de diagnóstico para planificar un tratamiento quirúrgico completo y efectivo, así como el tratamiento médico.


Assuntos
Humanos , Masculino , Adolescente , Infecções Estreptocócicas , Sinusite Maxilar/diagnóstico por imagem , Streptococcus anginosus , Abscesso/microbiologia , Tomografia Computadorizada por Raios X/métodos , Sinusite Maxilar/cirurgia , Dacriocistite/microbiologia , Infecção Focal Dentária/complicações , Infecção Focal Dentária/terapia , Seio Maxilar/cirurgia , Seio Maxilar/diagnóstico por imagem , Meningite
17.
Int J Syst Evol Microbiol ; 70(8): 4576-4582, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32735207

RESUMO

A strain of an obligately anaerobic, Gram-stain-negative rod-shaped bacterium is described by phenotypical, biochemical and genotypical characterization. This strain A2879T was isolated from an abscess swab of a patient sampled during routine care at hospital. Phylogenetic analyses (full-length 16S rRNA gene and whole-genome sequence) revealed the strain to belong to the genus Prevotella, but to be distant from recognized species, with the closest relationship to Prevotella veroralis. Unambiguous identification also proved possible by MALDI-TOF MS. The genomic DNA G+C content was 41.5 mol%. Strain A2879T was moderately saccharolytic and proteolytic. The most abundant cellular long-chain fatty acids were anteiso-C15 : 0 and iso-C15 : 0. In view of these data, strain A2879T is considered to represent a novel species within the genus Prevotella, for which the name Prevotella vespertina sp. nov. is proposed. The type strain is A2879T (=DSM 108027T=CCOS 1233T=CCUG72808T). As this strain has been isolated from a clinical sample, it is considered relevant for human medicine and health in general, and in particular for the fields of clinical microbiology and infectious diseases. This description will enable routine and research laboratories alike to easily identify the novel taxon, allowing its role in the context of human health and disease or microbiota to be further elucidated.


Assuntos
Abscesso/microbiologia , Filogenia , Prevotella/classificação , Adulto , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Alemanha , Humanos , Masculino , Prevotella/isolamento & purificação , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
18.
BMC Infect Dis ; 20(1): 566, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746887

RESUMO

BACKGROUND: Subtenon injection of triamcinolone acetonide (STTA) has been widely adopted in the clinical setting of ophthalmology and its infectious complications are rare. However, orbital abscess following STTA has been reported in seven cases. Furthermore, although eye infections due to Exophiala species are uncommon, there have been 19 cases to date. E. jeanselmei, E. phaeomuriformis, E. werneckii, and E. dermatitidis have been reported to cause human eye infections; however, to the best of our knowledge, orbital abscess caused by E. dermatitidis has not yet been reported. We describe the first documented case of fungal orbital abscess caused by E. dermatitidis following STTA. We also review the related literature of orbital abscess following STTA, as well as eye infections caused by the four Exophiala species. CASE PRESENTATION: The patient was a 69-year-old Japanese woman with diabetic mellitus. She had a macular oedema in her right eye, which occurred secondary to branch retinal vein occlusion. An orbital abscess caused by E. dermatitidis occurred 4 months after the second STTA for the macular oedema, which was successfully treated by a surgical debridement and systemic administration of voriconazole. CONCLUSIONS: Our findings in the patient and from our literature survey caution ophthalmologists to the fact that STTA can cause fungal orbital infections, especially in diabetic patients. Furthermore, surgical treatment is one of the most important risk factors.


Assuntos
Anti-Inflamatórios/efeitos adversos , Dermatite/diagnóstico , Exophiala/isolamento & purificação , Infecções Oculares/diagnóstico , Triancinolona Acetonida/efeitos adversos , Abscesso/microbiologia , Idoso , Anti-Inflamatórios/uso terapêutico , Antifúngicos/uso terapêutico , Dermatite/tratamento farmacológico , Dermatite/microbiologia , Infecções Oculares/tratamento farmacológico , Infecções Oculares/microbiologia , Feminino , Humanos , Edema Macular/diagnóstico , Edema Macular/etiologia , Triancinolona Acetonida/uso terapêutico , Voriconazol/uso terapêutico
20.
BMC Infect Dis ; 20(1): 621, 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32831057

RESUMO

BACKGROUND: We aimed to describe an outbreak of cutaneous abscesses caused by Panton-Valentine leukocidin (PVL)-producing methicillin-susceptible Staphylococcus aureus (MSSA) among gold mine workers. METHODS: In February 2018, we retrospectively reviewed a random sample of 50 medical records from 243 cases and conducted face-to-face interviews using a structured questionnaire. Pus aspirates were sent to the National Institute for Communicable Diseases from prospectively-identified cases (November 2017-March 2018). Nasopharyngeal swabs were collected during a colonisation survey in February 2018. Staphylococcus aureus isolates were screened with a conventional PCR for lukS/F-PV. Pulsed-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness among the isolates. A sample of isolates were selected for whole genome sequencing (WGS). We conducted an assessment on biological risks associated with mining activities. RESULTS: From January 2017 to February 2018, 10% (350/3582) of mine workers sought care for cutaneous abscesses. Forty-seven medical files were available for review, 96% were male (n = 45) with a mean age of 43 years (SD = 7). About 52% (24/46) were involved in stoping and 28% (13/47) worked on a particular level. We cultured S. aureus from 79% (30/38) of cases with a submitted specimen and 14% (12/83) from colonisation swabs. All isolates were susceptible to cloxacillin. Seventy-one percent of S. aureus isolates (30/42) were PVL-PCR-positive. Six PFGE clusters were identified, 57% (21/37) were closely related. WGS analysis found nine different sequence types. PFGE and WGS analysis showed more than one cluster of S. aureus infections involving closely related isolates. Test reports for feed and product water of the mine showed that total plate counts were above the limits of 1000 cfu/ml, coliform counts > 10 cfu/100 ml and presence of faecal coliforms. Best practices were poorly implemented as some mine workers washed protective clothing with untreated water and hung them for drying at the underground surface. CONCLUSIONS: PVL-producing MSSA caused an outbreak of cutaneous abscesses among underground workers at a gold mining company. To our knowledge, no other outbreaks of PVL-producing S. aureus involving skin and soft tissue infections have been reported in mining facilities in South Africa. We recommend that worker awareness of infection prevention and control practices be strengthened.


Assuntos
Abscesso/microbiologia , Dermatopatias/epidemiologia , Infecções dos Tecidos Moles/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/patogenicidade , Adulto , Toxinas Bacterianas/metabolismo , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado , Exotoxinas/metabolismo , Feminino , Ouro , Humanos , Leucocidinas/metabolismo , Masculino , Meticilina/farmacologia , Pessoa de Meia-Idade , Mineradores , Estudos Retrospectivos , Dermatopatias/microbiologia , Infecções dos Tecidos Moles/microbiologia , África do Sul/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética , Staphylococcus aureus/metabolismo
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