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1.
BMC Infect Dis ; 22(1): 557, 2022 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-35717143

RESUMO

BACKGROUND: Splenic cyst complicated by non-typhoid Salmonella infection is rare in healthy individuals in the era of antibiotics. Salmonella enterica subsp. enterica serovar Livingstone causing infection of giant splenic cyst has not been previously reported. CASE PRESENTATION: We report a case of giant splenic cyst (maximum diameter, 21 cm) complicated with Salmonella Livingstone infection, which resulted in splenic abscess, in a 16-year-old previously healthy adolescent male. The splenic abscess was successfully treated with ultrasonography-guided percutaneous drainage and antimicrobial therapy. CONCLUSION: Infection of splenic cyst may be caused by S. Livingstone in immunocompetent individuals. This case may help clinicians to raise awareness towards splenic abscess and highlights the importance of drainage and antimicrobial agents to avoid splenectomy.


Assuntos
Abscesso Abdominal , Cistos , Infecções Intra-Abdominais , Infecções por Salmonella , Salmonella enterica , Esplenopatias , Abscesso Abdominal/tratamento farmacológico , Abscesso/tratamento farmacológico , Adolescente , Antibacterianos/uso terapêutico , Drenagem/métodos , Humanos , Infecções Intra-Abdominais/tratamento farmacológico , Masculino , Salmonella , Infecções por Salmonella/complicações , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/tratamento farmacológico , Sorogrupo , Esplenopatias/complicações , Esplenopatias/diagnóstico , Esplenopatias/cirurgia
2.
BMC Musculoskelet Disord ; 23(1): 589, 2022 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-35717153

RESUMO

BACKGROUND: There are considerable differences in the treatment strategy for spinal tuberculosis, including conservative or surgical procedures. Conservative treatment is always suitable for most patients. This study aimed to compare the clinical efficacy of traditional conservative treatment with CT-guided local chemotherapy strategy of mild spinal tuberculosis. METHODS: This research retrospectively analysed 120 patients with spinal tuberculosis between January 2005 and January 2016 according to the diagnostic criteria of mild spinal tuberculosis. In total, 89 patients underwent traditional conservative treatment, 31 underwent CT-guided local chemotherapy. Clinical outcome, laboratory indexes, and radiological results were analysed to provide a clinical basis for the choice of mild spinal tuberculosis treatment. RESULTS: All cases achieved a clinical cure with 24 to 50 months followed up. Cobb angle of the two groups spinal tuberculosis segments was 6.25 ± 3.1100B0, 5.69 ± 2.5800B0 before treatment and 12.36 ± 6.3100B0, 14.87 ± 7.2600B0 after treatment, respectively. The VAS scores were significantly decreased post-treatment. At the 1 month follow-up, the VAS scores and erythrocyte sedimentation rate (ESR) were significantly differences between the two groups. The efficacy in the CT-guided local chemotherapy (Group B) was better than the traditional conservative treatment (Group A). But from the 3 months follow-up to the last follow-up, the VAS scores and ESR was no significant differences between the two groups and the average ESR decreased to normal. There was no evident kyphosis, symptoms or neurological deficits at the final follow-up. The paravertebral abscesses had disappeared, with no significant progression of local kyphosis, significant absorption and clear lesion edges, pain relief and normal ESR in the two groups. CONCLUSIONS: For mild spinal tuberculosis, traditional conservative treatment can achieve satisfactory results. The strategy combined with CT-guided local chemotherapy treatment is minimally invasive, beneficial for the drainage of paravertebral abscesses and pain relief.


Assuntos
Cifose , Fusão Vertebral , Tuberculose da Coluna Vertebral , Abscesso , Tratamento Conservador , Desbridamento/métodos , Humanos , Cifose/cirurgia , Vértebras Lombares/cirurgia , Dor , Estudos Retrospectivos , Fusão Vertebral/métodos , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Tuberculose da Coluna Vertebral/tratamento farmacológico
3.
BMJ Case Rep ; 15(6)2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35732366

RESUMO

A man in his 50s with type 2 diabetes mellitus (T2DM) presented with a nasal septal abscess 3 weeks following septoplasty. Diabetes mellitus has been reported in association with nasal septal abscess, thought to be due to a relative immunodeficient state. We present an unusual, delayed presentation of nasal septal abscess following septoplasty and performed a literature review. Nasal septal abscess is rare. It is associated with significant complications if not diagnosed and management expediently. The association between T2DM and nasal septal abscess following septoplasty emphasises the importance of good perioperative blood sugar control and postoperative nasal care and raises the question of empirical antibiotics in this group.


Assuntos
Carbúnculo , Diabetes Mellitus Tipo 2 , Obstrução Nasal , Doenças dos Seios Paranasais , Doenças Faríngeas , Infecções Respiratórias , Rinoplastia , Abscesso/cirurgia , Carbúnculo/complicações , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/cirurgia , Humanos , Masculino , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Doenças dos Seios Paranasais/complicações , Doenças Faríngeas/cirurgia , Infecções Respiratórias/complicações , Rinoplastia/efeitos adversos
4.
BMC Infect Dis ; 22(1): 566, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35733094

RESUMO

BACKGROUND: Cervicofacial space infections are potentially life-threatening, which require accurate diagnosis, early incision, and adequate drainage. The utilization of computed tomography (CT) in cervicofacial space infections has significantly increased for its advantages in the evaluation of abscesses, its availability, and low cost. However, the clinical value of preoperative CT imaging in cervicofacial space infections remains controversial for its poor specificity, radiation exposure, potential complications, and extra cost. We, therefore, investigated whether CT examination should be used as a routine examination in the treatment of patients with cervicofacial space infections. METHODS: A retrospective study of all patients affected by cervicofacial space infections that received incision and drainage surgery from Jan 2016 to Dec 2020 was performed at West China Hospital of Stomatology at Sichuan University. Patients were divided into two groups: the group with preoperative CT and without preoperative CT. Outcomes, including reoperation rate, missed diagnosis rate, days of symptom relief, length of stay, duration of surgery, and total cost of hospitalization, were analyzed. RESULTS: Out of n = 153 patients, 108 patients underwent surgery with preoperative CT and 45 patients without preoperative CT. The reoperation rate in the preoperative CT group (6/108, 5.6%) was significantly lower (P = 0.00) than that in the group without preoperative CT (10/45, 22.2%). Significant reduction of missed diagnosis rate (P = 0.00), days of symptom relief (P = 0.01), length of stay(P = 0.03), and duration of surgery (P = 0.01) were detected in the preoperative CT group. The results demonstrated that the utilization of preoperative CT can reduce the missed diagnosis rate and repeated surgery complications. CONCLUSIONS: We recommend preoperative CT as a routine examination in cervicofacial space infections.


Assuntos
Abscesso , Tomografia Computadorizada por Raios X , Abscesso/tratamento farmacológico , Drenagem/métodos , Humanos , Reoperação , Estudos Retrospectivos
5.
Andes Pediatr ; 93(2): 222-228, 2022 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-35735301

RESUMO

Kidney abscess is an unusual entity in childhood with few studies about its clinical characteris tics. OBJECTIVE: To report the clinical presentation, diagnosis, and therapy used in a cohort of 20 children with kidney abscess. PATIENTS AND METHOD: retrospective study of cases of kidney abscess during a 10-year period at the Hospital Roberto del Río. The analysis of clinical, laboratory, and imaging characteristics were evaluated as well as the treatment usedfor this condition. RESULTS: 20 cases were reported among which 65% were women with a median age of 3.6 years. The most com mon clinical presentation was fever, vomit, and dysuria. Eighty percent of patients presented an increase of inflammatory parameters, 88% presented positive urine culture, and the most common organism identified was Escherichia Coli (77.8%). The diagnosis was mostly made through kidney ultrasound (75%) followed by an abdominal CT scan (35%). 93% of abscesses were unilateral. About 95% of the patients only required antibiotic treatment. Vesicoureteral reflux was diagno sed in 28% of the patients with no sphincter control, and only one of them presented high-grade reflux. In patients with sphincter control, bladder and bowel dysfunction (BBD) was diagnosed in 90% of the cases. Forty four percent of the patients with late DMSA renal scintigraphy presented renal scarring. CONCLUSIONS: In this series, pediatric kidney abscess appears with persistent fever despite the treatment, requiring prolonged antibiotic therapy and rarely surgical drains. We su ggest a study aimed at detecting modifiable factors, such as vesicoureteral reflux in patients with no sphincter control and BBD in patients with sphincter control, as well as identifying renal paren chymal sequels in all patients.


Assuntos
Abscesso Abdominal , Nefropatias , Infecções Urinárias , Refluxo Vesicoureteral , Abscesso Abdominal/complicações , Abscesso Abdominal/tratamento farmacológico , Abscesso/complicações , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Nefropatias/complicações , Nefropatias/diagnóstico , Masculino , Estudos Retrospectivos , Infecções Urinárias/complicações , Infecções Urinárias/diagnóstico , Infecções Urinárias/tratamento farmacológico , Refluxo Vesicoureteral/complicações , Refluxo Vesicoureteral/tratamento farmacológico
6.
Pediatr Emerg Care ; 38(7): e1348-e1354, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35766929

RESUMO

OBJECTIVE: The aim of the study was to evaluate skin and soft tissue infection (SSTI) treatment and prevention practices among pediatric emergency medicine (PEM) clinicians in the context of current clinical practice guidelines and contemporary evidence. METHODS: This was a cross-sectional survey of PEM clinicians belonging to the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. Four varying hypothetical clinical scenarios of children with SSTI were posed to respondents; subsequent items assessed SSTI treatment and prevention practices. Provider demographics were collected. RESULTS: Of 160 survey respondents, more than half stated that they would prescribe oral antibiotics for each clinical scenario, particularly for more complex presentations (small uncomplicated abscess, 51.8%; large uncomplicated abscess, 71.5%; recurrent abscess, 83.5%; febrile abscess, 90.3%; P < 0.001). Most commonly selected antibiotics were clindamycin and trimethoprim-sulfamethoxazole. Across scenarios, more than 80% selected a duration of treatment 7 days or more. Of the 121 respondents who prescribe preventive measures, 85.1% recommend hygiene measures; 52.5% would prescribe decolonization with topical antibiotic ointment and 77.5% would recommend antiseptic body washes. Half of the respondents reported that their institution has standard guidance for SSTI management. CONCLUSIONS: Although current evidence supports adjuvant antibiotics for all drained SSTI and decolonization for the index patient and household contacts, PEM clinicians do not consistently adhere to these recommendations. In light of these findings, development and implementation of institutional guidelines are necessary to aid PEM clinicians' point-of-care decision making and improving evidence-based practice.


Assuntos
Medicina de Emergência , Medicina de Emergência Pediátrica , Infecções dos Tecidos Moles , Abscesso , Antibacterianos/uso terapêutico , Criança , Estudos Transversais , Humanos , Pomadas , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções dos Tecidos Moles/prevenção & controle , Estados Unidos
7.
Biomed Res Int ; 2022: 2266347, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35769666

RESUMO

Background: Seeking conventional oral health care for various dental conditions is still a challenge for many worldwide and poses a global public health challenge. It is not until the individual starts experiencing pain and disfigurement of the facial profile that they seek dental care after many self-care interventions have failed. This study sought to determine perceived knowledge, attitude, practice, and satisfaction of dental abscess management among dental abscess patients (DAPs). Methods: The research used a cross-sectional design to collect data from patients who visited the Dental Department of Effiduase Government Hospital with dental abscess from 6 May 2020-27 August 2020. A total sample size of 82 was selected from a population of 377. About 76 DAPs who met the inclusion criteria and consented to participate were interviewed. Results: About 57% of respondents believed that dental caries caused their abscess. However, 46% sought medical treatment between 0 and 2 weeks after the onset of their dental abscess, while the rest did that after 3 weeks. Close to 64.5% have ever had episode of abscess before current one which they managed with alternative treatment. About 95% of respondents saw the hospital as a good place for dental care. A significant association was established between patient's level of education and influence to seek orthodox treatment (p = 0.015, Fisher's exact test (FET)). Another significant association was established between patient's level of education and the kind of alternative treatment they used (p = 0.016, Fisher's exact test (FET)). Conclusions: Most DAPs believe that dental caries was the main cause of dental abscess. DAPs sought late medical care, after they have tried a failed alternative treatment. DAPs expressed satisfaction with reception, equipment and materials, and medicines used. Majority of the patients rated the cost of dental care in the facility as affordable.


Assuntos
Cárie Dentária , Conhecimentos, Atitudes e Prática em Saúde , Abscesso/terapia , Estudos Transversais , Cárie Dentária/epidemiologia , Cárie Dentária/terapia , Gana/epidemiologia , Humanos
8.
BMC Infect Dis ; 22(1): 549, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35705895

RESUMO

BACKGROUND: Melioidosis caused by Burkholderia pseudomallei is an emerging infection in Sri Lanka with a high case fatality rate. The disease usually manifests as pneumonia, however multisystem involvement is common. Myositis is an extremely rare occurrence and this is the only documented case where the initial presentation of melioidosis has been myositis and later complicated to myonecrosis. CASE PRESENTATION: A 45-year-old gentleman with pre-existing diabetes presented with a tender, right thigh lump for 1 week duration without any history of trauma or infection. Investigations revealed neutrophil leukocytosis, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels whilst ultrasonography showed focal myositis of right quadriceps. The patient went into sepsis amidst antibacterial treatment which warranted urgent surgery. At surgery, a large intramuscular abscess with myonecrosis was observed within vastus medialis which was completely drained and pus was taken for culture which eventually isolated Burkholderia pseudomallei. Melioidosis was diagnosed and intravenous meropenem was prescribed for 3 weeks. Following complete recovery, the patient was discharged on doxycycline and trimethoprim sulfamethoxazole for 3 months. CONCLUSIONS: Melioidosis, an endemic disease in south east Asia and northern Australia, is an emerging infection in Sri Lanka. Myositis is a rare presentation of the disease that can lead to myonecrosis and abscess formation which can cause rapid disease escalation and sepsis. Early surgical intervention may be life-saving in such cases where antibiotic therapy alone may not suffice.


Assuntos
Burkholderia pseudomallei , Melioidose , Miosite , Sepse , Abscesso/microbiologia , Antibacterianos/uso terapêutico , Humanos , Masculino , Melioidose/complicações , Melioidose/diagnóstico , Melioidose/tratamento farmacológico , Pessoa de Meia-Idade , Miosite/complicações , Miosite/diagnóstico , Sepse/complicações , Sepse/etiologia , Sri Lanka
9.
Zhongguo Dang Dai Er Ke Za Zhi ; 24(6): 705-710, 2022 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-35762439

RESUMO

A boy, aged 11 years, was admitted due to intermittent fever for 15 days, cough for 10 days, and "hemoptysis" for 7 days. The boy had fever and cough with left neck pain 15 days ago, and antibiotic treatment was effective. During the course of disease, the boy developed massive "hemoptysis" which caused shock. Fiberoptic bronchoscopy revealed a left pyriform sinus fistula with continuous bleeding. In combination with neck and vascular imaging examination results, the boy was diagnosed with internal jugular vein injury and thrombosis due to congenital pyriform sinus fistula infection and neck abscess. The boy was improved after treatment with temperature-controlled radiofrequency ablation for the closure of pyriform sinus fistula, and no recurrence was observed during the follow-up for one year and six months. No reports of massive hemorrhage and shock due to pyriform sinus fistula infection were found in the searched literature, and this article summarizes the clinical features, diagnosis, and treatment of this boy, so as to provide a reference for the early diagnosis of such disease and the prevention and treatment of its complications.


Assuntos
Fístula , Choque , Abscesso/diagnóstico , Abscesso/etiologia , Abscesso/cirurgia , Tosse , Febre/complicações , Fístula/complicações , Fístula/diagnóstico , Fístula/cirurgia , Hemoptise/complicações , Humanos , Masculino , Pescoço
10.
Comput Math Methods Med ; 2022: 6411935, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35685902

RESUMO

Objective: A case-control study was employed to retrospectively analyze the value of transrectal ultrasound in the preoperative diagnosis of complex anal fistula (CAF). Methods: The clinical data of 128 patients with CAF treated in our hospital from March 2019 to June 2021 were analyzed retrospectively. All patients were examined by transrectal ultrasound and MRI with Hitachi HI Vision Ascendus ultrasound diagnostic apparatus and MRI. The general data of the patients (age, sex, course of disease, complications, and previous operation history) and ultrasonic image characteristics were recorded. The consistency of internal orifice, head, branch/abscess, and abscess detected by ultrasound, MRI, and ultrasound combined with MRI were compared, and the sensitivity, accuracy, and specificity of ultrasound, MRI, and the combination of ultrasound and MRI (ultrasound+MRI) in the diagnosis of different Parks classification of anal fistula (AF) were compared. Results: The ultrasound images of the rectal probe in typical cases were compared with the MRI images. The characteristics of the ultrasound images were as follows: the outer orifice of AF was a thin strip of mixed echo or low echo leading to the skin side, and the inner orifice showed local dilated low echo, mixed echo, or interruption of mucosal continuity. The following are the MRI image features: abnormal long bar signal shadow from the dorsal side of the end of the coccyx to the S5 plane, low signal on T1WI, high signal on T2WI, blurred boundary, uneven signal, bifurcation in the lower end of the tail for "Y" shape, one branch opening at the body surface at about 6 o'clock, the other walking horizontally, passing through the levator ani muscle to the right posterior position of the rectum at about 6:00 o'clock, and penetrating the inner mouth of the rectum at 6 o'clock. The detection of internal orifice, head, branch/abscess, and abscess were compared by three examination methods. There was significant difference in the detection rate of internal orifice and branch/purulent cavity among the three methods (P < 0.05). The detection rates of internal mouth and branch/abscess cavity by ultrasound and MRI (94.77% and 94.94%) were higher than those by single ultrasound (75.16% and 79.78%) and MRI (81.05% and 83.15%) (P < 0.05). There was no significant difference in the detection rate of ultrasound, MRI internal orifice, and branch/purulent cavity (P > 0.05). There was no significant difference in the detection rate of supervisor and abscess among the three methods (P > 0.05). The results of operation included transsphincter type (n = 53), intersphincter type (n = 45), and superior sphincter type (n = 30). Analysis of transsphincter type AF detected by three methods: 42 cases of transsphincter type AF and 86 cases of nonsphincter type AF were detected by ultrasound, 36 cases of transsphincter type AF and 92 cases of nontranssphincter type AF were detected by MRI, 57 cases of transsphincter type AF and 71 cases of nonsphincter type AF were detected by ultrasound and MRI. The comparison of the efficacy of the three methods in the diagnosis of transsphincter AF and the sensitivity of the three methods in the diagnosis of transsphincter AF showed significant difference (P < 0.05). The sensitivity of ultrasound and MRI in the diagnosis of transsphincter AF (96.23%) was higher than those of single ultrasound (67.92%) and MRI (64.15%) (P < 0.05). There was no significant difference in the accuracy and specificity of the three methods in the diagnosis of transsphincter AF (P > 0.05). There were 41 cases of intersphincter type AF and 87 cases of nonsphincter type AF detected by ultrasound, 38 cases of intersphincter type AF and 90 cases of nonsphincter intersphincter type AF detected by MRI, and 45 cases of intersphincter type AF and 83 cases of nonsphincter intersphincter type AF detected by ultrasound and MRI. The sensitivity and accuracy of the three methods in the diagnosis of intersphincter AF were statistically significant (P < 0.05). The sensitivity and accuracy (100.00% and 100.00%) of ultrasound and MRI in the diagnosis of intersphincter AF were higher than those of single ultrasound (66.67% and 79.69%) and MRI (71.11% and 85.16%) (P < 0.05). There was no significant difference in the specificity of the three methods in the diagnosis of intersphincter AF (P > 0.05). The results of three methods were compared, including 24 cases of superior sphincter type AF and 89 cases of nonsuperior sphincter type AF, 21 cases of superior sphincter type AF, and 107 cases of nonsuperior sphincter type AF detected by MRI and 93 cases of superior sphincter type AF and 128cases of nonsuperior sphincter type AF detected by ultrasound and MRI. There was no significant difference in the sensitivity, accuracy, and specificity of the three methods in the diagnosis of superior sphincter AF (P > 0.05). Conclusion: The sphincter, anorectal, and surrounding tissues were clearly demonstrated by transrectal ultrasound. The internal orifice, head, branch/abscess, abscess, and the relationship between abscess and sphincter in the diagnosis of CAF were in good agreement with the surgical results. Ultrasound+MRI can take into account the advantages of ultrasound and MRI, make up for each other, and improve the detection rate of internal orifice and branch/abscess. It can improve the sensitivity of diagnosis of transsphincter AF and the sensitivity and accuracy of intersphincter AF, which can provide intuitive and valuable imaging information for surgical intervention.


Assuntos
Canal Anal , Fístula Retal , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Canal Anal/diagnóstico por imagem , Canal Anal/cirurgia , Estudos de Casos e Controles , Humanos , Fístula Retal/complicações , Fístula Retal/diagnóstico por imagem , Fístula Retal/cirurgia , Estudos Retrospectivos
11.
Medicine (Baltimore) ; 101(24): e29395, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35713445

RESUMO

RATIONALE: Prompt diagnosis of nontuberculous Mycobacterial (NTM) vertebral osteomyelitis is challenging, yet necessary to prevent serious morbidity and mortality. Here, we report 3 cases of vertebral osteomyelitis caused by NTM with imaging findings. PATIENT CONCERNS: Case 1, a 58-year-old male patient, was admitted to our hospital because of the presence of a pulmonary mass for 6 months with cough and chest pain.Case 2, a 50-year-old male patient, had fever and cough for 3 years and was diagnosed with tuberculosis. Antituberculosis treatment was ineffective, accompanied by lymph node enlargement and osteosclerotic changes involving vertebral bodies.Case 3, a 66-year-old female patient, was admitted to our hospital with a mass on the top of her head for 1 month, which ruptured in the last 2 weeks. DIAGNOSES: Case 1: Sputum culture revealed Mycobacterium (M.) avium.Case 2: The final culture results of the lymph node biopsy samples were M. intracellulare.Case 3: Culture results of the sputum and pus from the abscess were M. gordon.We found sclerosing lesions in the spine in all 3 NTM patients, which were easily misdiagnosed as metastatic tumors. In 2 cases, there was bone destruction in the ilium with limbic sclerosis, and there were abscesses near the ilium and in front of the sacrum in 1 case. INTERVENTIONS: Case 1 was transferred to other specialist hospital.Case 3 received surgical treatment for cranial lesions and abscess drainage.Case 2 and case 3 received targeted treatment for nontuberculous mycobacteria in our hospital. OUTCOME: The condition of case 1 was unknown.Recovery of case 2 was uneventful because of prolonged illness; however, inflammation gradually improved overall.Case 3 had no recurrence following surgical treatment. LESSONS: In our 3 cases of NTM vertebral osteomyelitis, bone lesions were often misdiagnosed as bony metastases because of the presence of multiple sclerotic lesions. Diagnoses were challenging and delayed. It is important to consider osteomyelitis by NTM when disseminated osteosclerosis with or without osteolytic bone lesions is present in conjunction with continuous inflammatory symptoms and signs. Moreover, an open biopsy of the lesion should be performed for a definitive diagnosis.


Assuntos
Infecções por Mycobacterium não Tuberculosas , Osteomielite , Abscesso/complicações , Idoso , Tosse/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Micobactérias não Tuberculosas , Osteomielite/diagnóstico por imagem , Osteomielite/etiologia
12.
Rozhl Chir ; 101(5): 251-254, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35667876

RESUMO

INTRODUCTION: Acute appendicitis is one of the most common acute abdominal conditions. One of its complications is postoperative formation of abscesses in the peritoneal cavity or in the retroperitoneal space. Among other things, appendicoliths left in the peritoneal cavity are responsible for this process. Their release from the lumen occurs preoperatively and during the operation. An appendicolith, with the bacteria present on its surface, provides an environment that supports the onset of an infection. CASE REPORT: The authors present a less common case of a retroperitoneal abscess caused by an incarcerated appendicolith. Unusual is the long period between appendectomy and clinical manifestations of the abscess. The patient underwent surgical treatment with abscess evacuation and extraction of the appendicolith. The postoperative course was adequate; wound healing was supported by negative wound pressure therapy. CONCLUSION: During appendectomy, it is necessary to keep in mind the risk of releasing appendicoliths and their role in infectious complications. A conscientious revision of the peritoneal cavity is required, as well as a good surgical technique. If necessary, imaging methods can help to locate the appendicolith in the postoperative period.


Assuntos
Abscesso Abdominal , Apendicite , Apêndice , Laparoscopia , Abscesso Abdominal/etiologia , Abscesso Abdominal/cirurgia , Abscesso/etiologia , Doença Aguda , Apendicectomia/efeitos adversos , Apendicectomia/métodos , Apendicite/complicações , Apendicite/cirurgia , Humanos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia
13.
Surg Infect (Larchmt) ; 23(5): 465-469, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35647894

RESUMO

Background: Non-surgical intervention has been proposed for the management of perianal abscess (PA) and fistula-in-ano (FIA), with potential benefits in terms of quality of life, wound healing, and functional outcome, although this strategy remains rare and controversial. Here, we aimed to compare the intermediate-term outcomes of non-surgical management with those of surgical incision and/or drainage. Patients and Methods: A study of pediatric patients with first-time PA and/or FIA was conducted retrospectively from January 2010 to December 2020. The patient population was stratified by surgical and non-surgical management. The clinical outcomes, including PA recurrence, FIA formation, and wound healing time, were compared between the surgical and non-surgical management groups. Results: A total of 457 patients managed for first-time PA and/or FIA were eligible for the current study. Of these patients, 169 (50.9%) patients received non-surgical intervention. There were no differences in terms of age, gender distribution, wound healing course, or abscess size between the two groups. Furthermore, no difference was noted between the two groups in terms of PA recurrence and/or FIA development rates and revisits for additional treatment. Conclusions: Although PA/FIA management is still controversial, non-surgical intervention exhibited promising outcomes for most cases of first-time PA/FIA, with fewer hospital admissions and surgical procedures and similar recurrence and fistula formation incidences. Immediate surgical intervention might be avoided because PA/FIA has a chance for spontaneous resolution in children.


Assuntos
Doenças do Ânus , Fístula Retal , Abscesso/cirurgia , Doenças do Ânus/cirurgia , Criança , Humanos , Qualidade de Vida , Fístula Retal/etiologia , Fístula Retal/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
14.
In Vivo ; 36(4): 1998-2001, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35738582

RESUMO

BACKGROUND: Gastric wall abscess (GWA) itself is a rare clinicopathological condition, and there has been no report of primary gastric cancer complicated by GWA. Herein, we present a case of advanced gastric cancer with intramural abscess, which was successfully treated with curative gastrectomy. CASE REPORT: A 77-year-old woman was admitted to the hospital for dull epigastric pain with inflammatory findings and diagnosed with advanced gastric cancer (cT4aN1M0 Stage III) with intramural abscess. Since an endoscopic ultrasonography-guided abscess drainage was not effective, after conservative therapy with antibiotics, she underwent distal gastrectomy with D2 lymphadenectomy and fortunately the tumor with abscess was safely and curatively removed without perforation. Microscopically, the 82×65 mm tumor invaded the subserosa and contained tubular adenocarcinoma with neuroendocrine cell carcinoma (pT3N0M0 Stage IIB), and the abscess formed from the ulcerative lesion of the cancer extended to the subserosa. The postoperative clinical course was uneventful, and she remained disease-free during the 22 months follow-up. CONCLUSION: Given the nature of the disease and the difficulty in endoscopic treatment, gastrectomy should be performed immediately for advanced gastric cancer with GWA to ensure control of both gastric cancer and infection.


Assuntos
Neoplasias Gástricas , Abscesso/diagnóstico , Abscesso/etiologia , Abscesso/cirurgia , Idoso , Feminino , Gastrectomia , Humanos , Excisão de Linfonodo , Neoplasias Gástricas/complicações , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia
15.
Medicine (Baltimore) ; 101(25): e29418, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35758376

RESUMO

RATIONALE: Double-J stents (DJSs) are urologic devices widely used for urinary tract obstruction treatment. Perinephric abscess is a condition with purulent accumulation resulting from urinary tract infection retained between the renal capsule and Gerota's fascia. Emphysematous urinary tract infection in patients with a forgotten DJS is extremely rare. Herein, we report a case of emphysematous perinephric abscess as a complication in a 56-year-old non-diabetic woman who neglected a 10-year-old DJS placed for obstructive uropathy treatment. PATIENT CONCERNS: The patient presented with fever and abdominal pain that persisted for 4 days. Laboratory examinations showed leukocytosis, hypoalbuminemia (2.3 g/dL), and elevated C-reactive protein level (305.5 mg/L) with no azotemia. DIAGNOSIS: Abdominal computed tomography scan revealed a DJS with encrustation and multiple stones in the right kidney as well as a perinephric abscess with gas formation. INTERVENTIONS: Intravenous administration of piperacillin/tazobactam was initiated immediately and percutaneous catheter drainage was performed. Extended-spectrum beta-lactamase-producing Escherichia coli was identified on abscess culture and antibiotics were switched to meropenem, resulting in gradual improvement of the inflammatory lesion. The patient was referred to the urology department for retained DJS removal and vesicolitholapaxy. A piece of fractured stent was removed via open ureterolithotomy. OUTCOMES: Since discharge on hospital day 42, she has been under regular follow-up, and the surgical wound has been healing with no significant sequelae. LESSONS: Prompt medical therapy for inflammation and thorough urologic correction of the stent-induced structural deformities are crucial in long-term neglected DJS and resulting emphysematous perinephric abscess. Patients who undergo DJS placement should be systematically followed up to prevent potential neglect of device management.


Assuntos
Abscesso Abdominal , Enfisema , Nefropatias , Ureter , Infecções Urinárias , Abscesso Abdominal/etiologia , Abscesso Abdominal/cirurgia , Abscesso/terapia , Criança , Enfisema/etiologia , Feminino , Humanos , Nefropatias/etiologia , Pessoa de Meia-Idade , Stents/efeitos adversos , Infecções Urinárias/complicações
16.
J Zoo Wildl Med ; 53(2): 424-432, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35758584

RESUMO

Bacterial abscesses are commonly seen in tortoises. The morbidity and the resultant mortality are high. Multifactorial problems, antibiotics misapplication. and antibiotic-resistant bacteria make abscess treatment complicated and ineffective. This study identifies the etiological bacterial species and determines the best antibiotics for abscess treatment in captive tortoises. Sterile swab specimens from 40 tortoises with abscesses were analyzed using the Analytical Profile Index (API) system. Sixty-five bacteria species were identified covering facultative anaerobic gram-negative (n = 30, 46.2%), facultative anaerobic gram-positive (n = 19, 29.2%), and aerobic gram-negative bacteria (n = 16, 24.6%). The antibiotic sensitivity of these bacteria to 30 antibiotics was assessed using the Kirby-Bauer disk-diffusion method. Greater than 80% anaerobic gram-negative bacterial species showed sensitivity to amikacin and ceftazidime. Greater than 80% anaerobic gram-positive bacterial species were sensitive to amoxicillin, ampicillin, carbenicillin, and penicillin. In addition, more than 80% aerobic gram-negative bacterial species were sensitive to ceftazidime, colistin sulphate, amikacin, gentamicin, kanamycin, polymyxin B, and tobramycin. This study provides clinicians significant information for initial antibiotic options, which could elevate the abscess therapy success rate and improve the life quality of tortoises.


Assuntos
Antibacterianos , Tartarugas , Abscesso/veterinária , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias , Ceftazidima , Bactérias Gram-Negativas , Testes de Sensibilidade Microbiana/veterinária
17.
Am J Case Rep ; 23: e935584, 2022 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-35751369

RESUMO

BACKGROUND Necrotizing fasciitis is a life-threatening infection of the deep soft tissues that leads to progressive destruction of the fascia and subcutaneous fat. It typically spreads along the muscle fascia planes because of the relatively poor blood supply. Muscle tissue is usually spared because of its better blood supply. The usual risk factors for necrotizing fasciitis include trauma, malnutrition, obesity, uncontrolled diabetes mellitus, alcoholism, cirrhosis, neutropenia, and recent surgery. CASE REPORT We present a case of a middle-aged female who presented with necrotizing fasciitis of the right gluteal region. Her medical history was significant for well-controlled diabetes mellitus (hemoglobin A1c: 6.6), and clear cell carcinoma of ovaries (stage IV). She was on active chemotherapy with bevacizumab, paclitaxel, and carboplatin. She underwent incision and debridement of right gluteal abscess with drainage of 200 ml of foul-smelling pus and was started on intravenous antibiotics. Her blood cultures were negative, but the cultures taken from the right gluteal abscess showed moderate growth of Escherichia coli. The antibiotics were de-escalated and the patient was discharged with outpatient follow-up. CONCLUSIONS Bevacizumab, a humanized monoclonal IgG antibody, is a novel treatment for metastatic ovarian cancer. It is associated with necrotizing fasciitis due to anti-angiogenic, pro-thrombotic, and poor wound healing properties. It should be stopped in the patients presenting with necrotizing fasciitis.


Assuntos
Fasciite Necrosante , Neoplasias Ovarianas , Abscesso/tratamento farmacológico , Antibacterianos/uso terapêutico , Anticorpos Monoclonais Humanizados , Bevacizumab/uso terapêutico , Fasciite Necrosante/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/tratamento farmacológico
20.
Infect Immun ; 90(6): e0017022, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-35575504

RESUMO

Many pathogenic microbial ecosystems are polymicrobial, and community function can be shaped by interbacterial interactions. Little is known, however, regarding the genetic determinants required for fitness in heterotypic community environments. In periodontal diseases, Porphyromonas gingivalis is a primary pathogen, but only within polymicrobial communities. Here, we used a transposon sequencing (Tn-Seq) library of P. gingivalis to screen for genes that influence fitness of the organism in a coinfection murine abscess model with the oral partner species Streptococcus gordonii and Fusobacterium nucleatum. Genes impacting fitness with either organism were involved in diverse processes, including metabolism and energy production, along with cell wall and membrane biogenesis. Despite the overall similarity of function, the majority of identified genes were specific to the partner species, indicating that synergistic mechanisms of P. gingivalis vary to a large extent according to community composition. Only two genes were identified as essential for P. gingivalis fitness in abscess development with both S. gordonii and F. nucleatum: ptk1, encoding a tyrosine kinase, and inlJ, encoding an internalin family surface protein. Ptk1, but not InlJ, is required for community development with S. gordonii, and we found that the action of this kinase is similarly required for P. gingivalis to accumulate in a community with F. nucleatum. A limited number of P. gingivalis genes are therefore required for species-independent synergy, and the Ptk1 tyrosine kinase network may integrate and coordinate input from multiple organisms.


Assuntos
Coinfecção , Porphyromonas gingivalis , Abscesso , Animais , Coinfecção/microbiologia , Ecossistema , Fusobacterium nucleatum/genética , Camundongos , Porphyromonas gingivalis/metabolismo , Proteínas Tirosina Quinases/metabolismo
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