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1.
Nihon Shokakibyo Gakkai Zasshi ; 119(8): 744-749, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-35944992

RESUMO

A female in her 60s was referred to our institution with epigastric pain and abdominal fullness persisting for one week. She was afebrile and mild abdominal tenderness was found on physical examination. Computed tomography (CT) revealed free air, and the dirty fat sign outside the duodenal wall. Her previous CT had not shown causative findings such as duodenal diverticula. A slightly high-attenuated linear structure penetrating the duodenal wall at the second portion was suspected after review of present CT images. Based on the history of her current illness, the possibility of mackerel bone ingestion was considered. Esophagogastroduodenoscopy (EGD) revealed a fishbone sticking out of the duodenal wall, which was extracted with biopsy forceps. Although antibiotic treatment under fasting was continued, the formation of retroperitoneal abscess was detected by CT on the 6th postprocedural day. Given that she also developed a high fever, surgical drainage was performed. The patient was discharged on the 15th postoperative day. Thus, in cases of duodenal perforations, a fishbone should be taken into account as a possible cause. Even if endoscopic removal was initially selected, careful observation is mandatory and an additional treatment should be considered depending on the clinical course.


Assuntos
Úlcera Duodenal , Perfuração Intestinal , Dor Abdominal/etiologia , Abscesso/complicações , Drenagem , Úlcera Duodenal/complicações , Duodeno/cirurgia , Feminino , Humanos , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia
2.
Front Immunol ; 13: 923341, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935931

RESUMO

Human brucellosis is one of the most prevalent zoonoses. There are many similarities between the pathogenesis of Mycobacterium tuberculosis (MTB) infection and that of brucellosis. Immune reconstitution inflammatory syndrome (IRIS) may occur during the treatment of MTB infection, but it has not been reported in brucellosis cases thus far. We report the case of a 40-year-old male whose condition initially improved after adequate anti-Brucella therapy. However, 3 weeks later, the patient presented with exacerbation of symptoms and development of a paravertebral abscess. After exclusion of other possible causes of clinical deterioration, immune reconstitution inflammatory syndrome (IRIS) with brucellosis was presumed. After supplementation with anti-Brucella treatment with corticosteroids, the abscess disappeared, and the symptoms completely resolved. Our case suggests that it is necessary to be aware of the possible occurrence of IRIS in patients with brucellosis in clinical practice.


Assuntos
Brucella , Brucelose , Síndrome Inflamatória da Reconstituição Imune , Mycobacterium tuberculosis , Abscesso/patologia , Adulto , Brucelose/complicações , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Humanos , Síndrome Inflamatória da Reconstituição Imune/diagnóstico , Síndrome Inflamatória da Reconstituição Imune/tratamento farmacológico , Síndrome Inflamatória da Reconstituição Imune/etiologia , Masculino
3.
Korean J Radiol ; 23(8): 785-793, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35914743

RESUMO

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving apocrine-bearing sites. It is characterized by recurrent painful nodules and abscesses that potentially rupture, resulting in sinus tract formation, fistulas, and scarring. HS tends to be found in the intertriginous areas (i.e., the axillary, inguinal, and perianal areas of the body). HS may be uncommon for radiologists because its diagnosis is usually based on clinical assessment. However, diagnosis based solely on clinical manifestations can underestimate the severity of HS. Ultrasonography and MRI play a critical adjunct role in determining the severity and extent of the disease and greatly aid its management. Given that MRI is an effective imaging tool, its role in the analysis of severe and anogenital HS lesions merits considerable attention. Unfortunately, anoperineal HS imposes diagnostic dilemmas. It has multiple symptoms and presentations and often mimics other diseases in the intertriginous areas. Therefore, a thorough understanding of HS is essential to avoid delayed diagnoses. This review highlights the typical MRI imaging features and staging of HS, emphasizing on the anoperineal location. The review also differentiates the disease from mimics to facilitate the prompt delivery of appropriate treatment and improve patients' quality of life.


Assuntos
Hidradenite Supurativa , Abscesso , Hidradenite Supurativa/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Dor , Qualidade de Vida
4.
Rev Med Liege ; 77(7-8): 426-429, 2022 Jul.
Artigo em Francês | MEDLINE | ID: mdl-35924496

RESUMO

With the development of modern imaging, incidental findings of renal neoplasia are increasingly frequent. However, renal cell carcinoma can also rarely present as an atypical form and can be confused with benign pathologies such as renal abscess or pyelonephritis. We present the case of a renal neoplasia largely mimicking a renal abscess.


Avec le développement de l'imagerie moderne, la découverte fortuite des néoplasies rénales est de plus en plus fréquente. Néanmoins, le carcinome rénal peut également rarement se présenter sous une forme atypique et peut alors être confondu avec des pathologies bénignes comme un abcès rénal ou une pyélonéphrite. Nous présentons le cas d'une néoplasie rénale se manifestant trompeusement sous la forme d'un abcès rénal.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Pielonefrite , Infecções Urinárias , Abscesso/diagnóstico , Carcinoma de Células Renais/diagnóstico , Diagnóstico Diferencial , Humanos , Neoplasias Renais/diagnóstico , Pielonefrite/diagnóstico
5.
J Can Dent Assoc ; 88: m2, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35881058

RESUMO

PURPOSE: The aim of this study was to explore a classification system for children requiring full-mouth dental rehabilitation (FMDR) in the operating room (OR) and its association with adverse events. METHODS: Patients treated at a pediatric dental residency clinic and determined to need FMDR in the OR were classified on initial examination, based on the extent of caries, pain and the presence of a dental abscess. On the treatment date, parents were given a questionnaire concerning adverse events that occurred while waiting for treatment. Χ2 tests of independence were used to determine associations between classification (OR code) and the occurrence of adverse events. The Pearson's r test was used to determine relations among adverse events and wait time. RESULTS: The study included 82 patients (age range 2-10 years, mean 4.73 years, median 4 years). The average wait time was 55.6 days. The most common OR classification was caries in the outer third of dentin without pain or abscess, and the most common adverse event was difficulty eating or drinking. The OR code category most closely associated with negative outcomes was the presence of a dental abscess, followed by caries depth, then pain. Wait time was not associated with the occurrence of adverse events. CONCLUSIONS: These data provide evidence to support the need for a classification system for children requiring FMDR in the OR. Dental abscess, caries depth and pain were associated with adverse events.


Assuntos
Anestesia Dentária , Cárie Dentária , Abscesso/complicações , Anestesia Dentária/efeitos adversos , Anestesia Geral/efeitos adversos , Criança , Pré-Escolar , Cárie Dentária/epidemiologia , Cárie Dentária/terapia , Humanos , Reabilitação Bucal , Dor/complicações
6.
BMC Infect Dis ; 22(1): 621, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35840925

RESUMO

BACKGROUND: Streptococcus canis is a group G beta-hemolytic Streptococcus species which normally resides on the skin and mucosal surfaces of dogs. Although it rarely causes infection in humans, our case and review of relevant literature demonstrate that this multi-host pathogen may be responsible for metastatic infection. We present an appropriate management strategy in such cases. CASE PRESENTATION: A previously healthy 26-year-old male presented to the emergency department with a 2-day history of erythema, pain, and swelling of the left ankle and foot, consistent with acute cellulitis. The patient was initially discharged home with a plan to complete a course of IV cefazolin as an outpatient, but later recalled after two sets of blood cultures grew gram positive cocci. Blood cultures speciated as Streptococcus canis. This was performed by identifying beta hemolytic strep on blood agar, then typed as Lancefield group G, followed by MALDI-TOF which distinguished S. canis. History was unremarkable except for a 2-week history of lower back pain precipitated by a wrestling injury. There was no canine bite or scratch wound, although the patient lives with a dog. CT spine was obtained which demonstrated right piriformis myositis and S1 osteomyelitis. MRI additionally demonstrated right erector spinae myositis, right sacroiliitis, and multiple collections in the right posterior paraspinal soft tissues. Transthoracic echocardiogram did not demonstrate valvular vegetations. The S. canis isolate was pan-susceptible and the patient was ultimately discharged home and completed a 8-week course of IV penicillin G. After completion of therapy, his symptoms, repeat imaging, and biochemical markers suggested resolution of infection on follow-up. CONCLUSIONS: We suggest that management of S. canis bacteremia should involve consideration of screening for metastatic infection and infectious diseases consultation. However, despite its potential for systemic involvement, S. canis is often susceptible to narrow spectrum antibiotics, and may be treated with penicillins.


Assuntos
Bacteriemia , Miosite , Osteomielite , Sacroileíte , Infecções Estreptocócicas , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Adulto , Animais , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Cães , Humanos , Masculino , Miosite/diagnóstico , Miosite/tratamento farmacológico , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus
7.
Biomed Res Int ; 2022: 3650213, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35832848

RESUMO

Background: Pelvic abscess surgery consists mostly of open laparotomy and laparoscopic surgery. Open surgery is regarded as a classic procedure. With the rise and promotion of laparoscopic indications in recent years, comparative studies of the two's postoperative effectiveness have been limited. Objective: To compare the clinical effects of laparoscopic exploratory surgery and open surgery in the treatment of pelvic abscess. Methods: Through computer searches of PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases, we found publicly available case-control research on laparoscopic surgery and open surgery for treating pelvic abscess. The papers that met the evaluation criteria were screened, and meta-analysis was used to look at 8 papers on laparoscopic surgery and open surgery for treating pelvic abscess from 2010 to 2021. Results: The results of this study showed that compared with the open laparotomy group, the incidence of laparoscopic group in the incision infection rate (RR = 0.29, 95% CI (0.20, 0.41), and P < 0.00001), the incidence of intestinal injury (RR = 0.08, 95% CI (0.04, 0.14), and P < 0.00001), incidence of intestinal obstruction (RR = 0.26, 95% CI (0.08, 0.90), and P = 0.03 < 0.05), and postoperative pelvic abscess recurrence rate (RR = 0.34, 95% CI (0.13, 0.86), and P = 0.02 < 0.05) are lower than open surgery, and the difference of these four items is statistically significant. There was no difference in the risk of urinary tract injury between laparoscopic surgery and open surgery (RR = 0.92, 95% CI (0.27, 3.17), and P = 0.89 > 0.05). Conclusion: In terms of incision infection, intestinal damage, intestinal obstruction, and recurrence of pelvic abscess, the laparoscopic group clearly outperforms the open group, and it merits clinical promotion and use.


Assuntos
Obstrução Intestinal , Laparoscopia , Abscesso/cirurgia , Colectomia/efeitos adversos , Humanos , Obstrução Intestinal/etiologia , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Laparotomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento
8.
Contrast Media Mol Imaging ; 2022: 5868453, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35833078

RESUMO

Pelvic inflammatory disease refers to a group of infectious diseases of the female upper genital tract, often caused by ascending infection of vaginitis and cervicitis, causing endometritis, salpingitis, tubo-ovarian abscess, pelvic connective tissue inflammation, and/or pelvic peritonitis. PID is the most common and important infectious disease in nonpregnant women of childbearing age, and inflammation in multiple parts often coexists and affects each other. The functional MRI techniques currently used in pelvic floor muscle injury are magnetic resonance diffusion tensor imaging, T2 mapping, and magnetic resonance elastography. Diffusion tensor imaging is a new imaging and postprocessing technology developed on the basis of magnetic resonance diffusion-weighted imaging. Due to the lack of specificity of clinical symptoms, many subclinical patients are often not detected and diagnosed in time, so it is very difficult to accurately estimate the incidence of PID. This article retrospectively analyzed 72 patients with pelvic inflammatory disease confirmed by surgical pathology from February 2020 to 2022, who had undergone pelvic MRI examination before surgery, including 25 patients with chronic pelvic inflammation (hydrosalpinx), 25 patients with acute pelvic inflammation, and 47 cases (including 21 cases of hydrosalpinx, 19 cases of tubo-ovarian abscess, and 7 cases of pelvic abscess). The age range was 13 to 59 years old. The clinical data and MRI findings were analyzed, the ADC value of the cystic part of the lesion was measured, and the differences in age, maximum diameter of the lesion, thickness of the vessel wall/separation, and the ADC value of the cystic part of chronic and acute pelvic inflammation were compared. In this part of the cases, there were 25 cases of chronic pelvic inflammation and 47 cases of acute pelvic inflammation. The average ADC value of the cystic component of chronic inflammation was significantly higher than that of acute inflammation, which were (2.86 ± 0.20) × 10-3 mm2/s and (1.07 ± 0.38) ×10-3 mm2/s, respectively, P value <0.001.


Assuntos
Doença Inflamatória Pélvica , Salpingite , Abscesso/diagnóstico , Adolescente , Adulto , Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doença Inflamatória Pélvica/diagnóstico por imagem , Doença Inflamatória Pélvica/patologia , Estudos Retrospectivos , Salpingite/diagnóstico , Adulto Jovem
9.
BMC Infect Dis ; 22(1): 613, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35836203

RESUMO

BACKGROUND: Campylobacter rectus is a gram-negative rod, and Parvimonas micra is a gram-positive coccus, both of which are oral anaerobes that cause chronic periodontitis. Chronic periodontitis can cause bacteremia and systemic diseases, including osteomyelitis. Hematogenous osteomyelitis caused by anaerobic bacteria is uncommon, and to date, there have been no reports of mixed bacteremia with C. rectus and P. micra. Here, we report the first case of osteomyelitis of the femur caused by anaerobic bacteria with mixed bacteremia of C. rectus and P. micra caused by chronic periodontitis. CASE PRESENTATION: A 75-year-old man with chronic periodontitis, hyperuricemia, and benign prostatic hyperplasia was admitted to the hospital with a fracture of the left femur. The patient had left thigh pain for 4 weeks prior to admission. Left femoral intramedullary nail fixation was performed, and a large amount of abscess and necrotic tissue was found intraoperatively. The cultures of abscess specimens were identified as P. micra, Fusobacterium nucleatum, and C. rectus. C. rectus and P. micra were also isolated from blood cultures. C. rectus was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16 S ribosomal RNA sequencing. Sulbactam-ampicillin was administered for approximately 1 month, after which it was replaced by oral clavulanic acid-amoxicillin for long-term suppressive treatment. CONCLUSIONS: Only five cases of bloodstream infection with C. rectus have been reported, and this is the first report of mixed bacteremia with P. micra. Clinicians should consider that chronic periodontitis caused by rare oral anaerobic bacteria can cause systemic infections, such as osteomyelitis.


Assuntos
Bacteriemia , Periodontite Crônica , Osteomielite , Abscesso/complicações , Idoso , Bacteriemia/complicações , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Bactérias Anaeróbias , Campylobacter rectus/genética , Periodontite Crônica/complicações , Fêmur , Firmicutes , Humanos , Masculino , Osteomielite/complicações , Osteomielite/tratamento farmacológico , Peptostreptococcus
10.
Eur Rev Med Pharmacol Sci ; 26(13): 4863-4871, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35856378

RESUMO

OBJECTIVE: Human brucellosis is a zoonosis with an extremely wide spectrum of clinical manifestations. Focal splenic involvement is very uncommon, particularly in the pediatric age group, during the illness' acute phase. CASE REPORT: A 4-year-old boy, already receiving third-generation cephalosporin treatment, was transferred from a local hospital to the University Pediatric Department for fever, anemia, increased inflammation index, and multiple, hyper-echogenic splenic lesions on abdominal ultrasound. Initial diagnostic laboratory investigations for Brucella infection, including the Widal-Wright test, were found to be negative. However, further diagnostic laboratory analysis using the chemiluminescent immunoassay was positive for Brucella IgM antibodies. Treatment with rifampicin at a dose of 150 mg/Kg/twice daily and co-trimethoprim at a dose of 80 mg/Kg/twice daily was started and continued for 7 weeks. IgM antibodies were undetectable after 2 weeks of treatment, and after 6 weeks of treatment, abdominal ultrasound documented a reduction of the diameter of the major splenic infiltrate from 1 to 0.5 cm. At 3 and 5 months of follow-up, re-evaluation of the abdominal lesions displayed complete resolution of the splenic lesions and a complete clinical recovery. CONCLUSIONS: The present case and a literature review are presented in this study since a standard diagnostic laboratory evaluation for brucellosis may miss the diagnosis, and in suspected cases, the laboratory analysis should be extended. Splenic abscesses are known to be rare in brucellosis, but the diagnosis should be considered in children with severe focal lesions, as specific antibiotic treatment may result in complete clinical recovery.


Assuntos
Brucelose , Esplenopatias , Abscesso , Antibacterianos/uso terapêutico , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Brucelose/patologia , Criança , Pré-Escolar , Humanos , Imunoglobulina M , Masculino , Esplenopatias/diagnóstico por imagem , Esplenopatias/tratamento farmacológico
11.
Medicine (Baltimore) ; 101(27): e29732, 2022 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-35801737

RESUMO

Duodenal stump fistula (DSF) is one of the most serious complications of gastrectomy. The mean time to diagnosis of DSF is approximately 9 days after operation. Our report describes an extremely rare case of delayed DSF 144 days after a laparoscopic distal gastrectomy. A 58-year-old man with drug-induced liver cirrhosis (Child-Pugh class A) underwent laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer. On postoperative day 1, he underwent reoperation because of intra-abdominal bleeding. Ongoing bleeding was observed in the stapler line of the duodenal stump and was controlled using metallic surgical clips. The patient was discharged on postoperative day 14, without complications. After 144 days following the first operation, he visited the emergency room with right flank pain and high fever. Computed tomography revealed free air and abscess near the duodenal stump site. Emergency laparotomy, abscess unlooping, and drain insertion were performed. After surgery, bile was drained by intra-abdominal drainage, and fistulography showed a duodenal fistula. The patient was discharged 55 days after his third surgery. This is an extremely rare case of DSF, which may be caused by the metallic surgical clips used for hemostasis of the duodenal stump stapler line. We believe that the use of metallic surgical clips for hemostasis of the duodenal stump after Billroth-II reconstruction should be avoided.


Assuntos
Duodenopatias , Fístula Intestinal , Laparoscopia , Neoplasias Gástricas , Abscesso/cirurgia , Duodenopatias/etiologia , Duodenopatias/cirurgia , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Humanos , Fístula Intestinal/complicações , Fístula Intestinal/cirurgia , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia
13.
Allergol Immunopathol (Madr) ; 50(4): 17-22, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35789399

RESUMO

INTRODUCTION: In recent decades, there has been a growing increase in the diagnosis of patients with inborn errors of the immune system, formerly known as primary immunodeficiency disorders (PIDs). Timely diagnosis remains a challenge due to low clinical suspicion and poor education on the subject. It is estimated that between 70% and 90% of these pathologies remain underdiagnosed in our environment. OBJECTIVE: The objective of this study is to characterize the demographic and clinical presentation of pediatric group patients with inborn errors of the immune system in a Colombian tertiary hospital. METHODS: Retrospective descriptive study of 306 patients with a diagnosis of innate errors of the immune system who consulted the PID clinic between 2011 and 2018 in a high-complexity institution in Cali, Colombia. RESULTS: Three-hundred and six patients were included. The median age was 4 years (IQR 2.3-7.7 years), and 59.5% of the patients were male. According to the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency classification for inborn errors of the immune system, the most common group was antibody deficiency in 74.8% (n˂229), especially in the age group between 1 and 5 years. The least frequent in our population was complement deficiency. Of the warning signs stipulated for these pathologies, the most frequent were the (1) need for intravenous antibiotics (32%), (2) difficulty growing (15.7%), (3) four or more episodes of ear infection (10.8%), and (4) abscesses in organs or cutaneous abscesses (12.7%). No patient reported two or more episodes of pneumonia or sinusitis, and only 5.8% of the patients received a bone marrow transplant. CONCLUSIONS: Innate errors of the immune system require an early diagnosis with follow-up from an early age to ensure adequate management and follow-up in order to reduce morbidity and mortality. It is imperative to sensitize the medical population about the existence of these pathologies so that early intervention can be carried out, which improves the quality of life of patients and their families.


Assuntos
Abscesso , Qualidade de Vida , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Humanos , Sistema Imunitário , Lactente , Masculino , Estudos Retrospectivos , Centros de Atenção Terciária
14.
Chirurgia (Bucur) ; 117(3): 357-361, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35792546

RESUMO

Background: Laparoscopic cholecystectomy has become a routine procedure in abdominal surgery, a "gold standard" in the treatment of gallstones. Iatrogenic perforation of the gallbladder during a cholecystectomy is a possible incident, with numerous complications due to unidentified intraperitoneal gallstones during surgery. Pulmonary complications of laparoscopic cholecystectomy are extremely rare. Case report: This report presents the case of a 62-year-old female with post cholecystectomy subphrenic abscess and trans-diaphragmatic fistula in the middle pulmonary lobe. In this case, the pulmonary symptoms dominated the clinical picture and the initial complementary explorations indicated a strictly pulmonary condition. The initial evolution of the patient was towards worsening, and the subsequent explorations established the real diagnosis. Conclusion: Gallbladder perforations with accidental loss of gallstones should be recognized immediately and managed. In the development of a pulmonary abscess, we can take into account an intra-peritoneal condition as well.


Assuntos
Colecistectomia Laparoscópica , Cálculos Biliares , Abscesso , Colecistectomia , Colecistectomia Laparoscópica/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
15.
Clin Med (Lond) ; 22(4): 370-372, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35882480

RESUMO

Thyroid abscess is rare but potentially fatal, whereas subclinical thyroiditis is a self-limiting condition that is more commonly seen. The clinical features of both diseases can be overlapping but the treatment approach differs. We report a case of a painful left thyroid nodule not responding to conventional therapy for thyroiditis or thyroid abscess.


Assuntos
Nódulo da Glândula Tireoide , Tireoidite Subaguda , Tireoidite , Abscesso/diagnóstico , Humanos , Nódulo da Glândula Tireoide/diagnóstico , Tireoidite/diagnóstico , Tireoidite Subaguda/diagnóstico
16.
Dig Dis Sci ; 67(9): 4369-4372, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35857242

RESUMO

Clinical presentation after ingestion of foreign body is a common finding in surgical practice. Perianal sepsis due to a foreign body is, usually, secondary to introduction via the trans-anal route. The case here reported is extremely rare since an ingested fishbone passed asymptomatically through most of the gastrointestinal tract, with resultant late-onset ischiorectal abscess. Moreover, clinical evidence of the perianal abscess manifested one month after the fishbone had been ingested. The final localization of the fishbone-lying anterior to the sacrum-complicated the preoperative and intraoperative detection of the ingested foreign body.


Assuntos
Doenças do Ânus , Corpos Estranhos , Abscesso/complicações , Abscesso/etiologia , Animais , Doenças do Ânus/etiologia , Doenças do Ânus/cirurgia , Peixes , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Refeições
17.
Front Public Health ; 10: 894638, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35875000

RESUMO

Objectives: To assess oral health and its implication on oral health-related quality of life (OHRQoL) among groups of foundling and delinquent children compared to mainstream children in Riyadh, Saudi Arabia. Materials and Methods: This cross-sectional observational study was conducted on children in care houses and mainstream school-going children. The following variables were measured for each group: Demographic data (age, gender); subjective oral health condition; (OHRQoL); clinical oral health condition including the decayed, missing, and filled teeth (DMFT) index; pulpally involved, ulceration, fistula, and abscess (PUFA) index; Dental Aesthetic Index (DAI) for malocclusion, and traumatic dental injuries (TDI). Statistical Analysis: A one-way ANOVA test, Chi-square test, and Pearson correlation coefficient were used. Results: The total OHRQoL score was significantly higher for the delinquent compared to the mainstream group. In addition, the DMFT and mean PUFA scores were significantly higher for the delinquent group than the others. The DAI revealed statistical significance in occlusion status within the foundling and delinquent groups, and the prevalence of TDI was significantly higher in the delinquent vs. the mainstream group. Conclusion: Oral health status appeared to have an association with the OHRQoL among foundling, delinquent, and mainstream children.


Assuntos
Fístula , Qualidade de Vida , Abscesso , Criança , Estudos Transversais , Humanos , Saúde Bucal
18.
Am J Case Rep ; 23: e936528, 2022 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-35906763

RESUMO

BACKGROUND Splenic abscess is a rare infectious disease that occurs after bloodstream infection and trauma. It has become more common due to an increase in the number of immunocompromised patients. They typically present with round cystic lesions demonstrated by ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). Clostridioides difficile (formerly Clostridium difficile) is a well-known cause of pseudomembranous colitis, but extraintestinal manifestations are very rare. To the best of our knowledge, only 9 cases of splenic abscess due to C. difficile have been reported in the literature. CASE REPORT A 90-year-old man presented with weight loss, fever, and abdominal pain. Contrast-enhanced CT revealed splenomegaly with irregular hypodense nodules. Image-guided biopsy or drainage was not performed for a technical reason. MRI showed atypical nodules with mixed high and low signals on both T1- and T2-weighted images, which were inconclusive. A laparoscopic splenectomy was performed, which resulted in partial removal due to severe adhesion of the spleen to the surrounding tissues. Cultures of splenic pus yielded C. difficile, Enterococcus faecium, and Bacteroides fragilis. Pathological examination of the spleen showed widespread abscesses with hemorrhage and necrosis, leading to the diagnosis of splenic abscesses. Intravenous administration of vancomycin, clindamycin or metronidazole was ineffective. He died of fatal arrhythmia 5 months after the initial diagnosis of splenic abscess. CONCLUSIONS Splenic abscess can present with atypical imaging findings owing to chronic inflammation, bleeding, and necrosis. Although polymicrobial, this is the tenth reported case of splenic abscess caused by C. difficile.


Assuntos
Abscesso Abdominal , Clostridioides difficile , Esplenopatias , Abscesso Abdominal/etiologia , Abscesso/etiologia , Idoso de 80 Anos ou mais , Clostridioides , Humanos , Masculino , Necrose , Esplenopatias/etiologia , Esplenopatias/cirurgia
19.
Adv Emerg Nurs J ; 44(3): 199-205, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35900239

RESUMO

Eye infection with or without swelling is a common complaint in pediatric patients. It commonly affects the eyelid, which can be confused with an insect bite, orbital pseudotumor, or panophthalmitis. The article highlights the differences between preseptal and orbital cellulitis. Preseptal and orbital cellulitis originate from other infections because of the thin bone barrier that separates the eye from other facial structures. The clinical manifestations of preseptal and orbital cellulitis may be perplexing, and emergency nurse practitioners must distinguish between the two infections. The incorrect diagnosis may lead to complications. The complications associated with orbital cellulitis are vision loss, brain abscess, vision loss, cavernous sinus thrombophlebitis, orbital cellulitis, subperiosteal abscess, and death. Thus, early diagnosis and treatment will prevent these complications.


Assuntos
Celulite Orbitária , Abscesso/diagnóstico , Abscesso/terapia , Antibacterianos/uso terapêutico , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/terapia , Criança , Edema , Humanos , Celulite Orbitária/tratamento farmacológico , Celulite Orbitária/terapia , Estudos Retrospectivos
20.
Medicine (Baltimore) ; 101(26): e29761, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35777008

RESUMO

BACKGROUND: Lactational mastitis and breast abscess cause trouble for women. It has been shown that oral probiotics can improve breast microecology, thus alleviating inflammatory responses. Our study aims to understand the long-term effect of Lactobacillus fermentum CECT5716 on patients with lactational breast abscess after needle aspiration. METHODS: Data continued in a randomized controlled study of 101 subjects with lactational abscess from 12 hospitals were included. They were randomly divided into an experimental group and a control group. After needle aspiration treatment, the experimental group was orally administrated with L fermentum CECT5716 for 4 consecutive weeks, while the control group was treated with maltodextrin in the same way). In the third month after randomized controlled trial, the subjects were followed up by an online questionnaire investigation. The observation indexes included the relief of breast pain, recurrence of mastitis from the end of oral administration to the follow-up, and the effect on continuing breastfeeding. RESULTS: A total of 101 patients were enrolled and 83 valid questionnaires were received during follow-up, including 40 in the experimental group and 43 in the control group. The rate of stop breastfeeding due to recurrence of mastitis was 2.5% (1/40) in the experimental group and 18.6% (8/43) in the control group, with a statistically significant difference (odds ratio = 0.112, 95% confidence interval: 0.013-0.942, P < .05). The rate of stop breastfeeding was 10% (4/40) in the experimental group and 25.6% (11/43) in the control group, without significant difference. The pain relief rate in the experimental group was 80% (32/40), which showed no significant difference from that in the control group, that is, 72.1% (31/43). The recurrence rate of mastitis in the experimental group was 20% (8/40), which was not significantly different from that in the control group, that is, 16.3% (7/43). CONCLUSIONS: In lactating women with a history of breast abscess, oral L fermentum CECT5716 may reduce the risk of stop breastfeeding due to recurrence of mastitis.


Assuntos
Empiema Pleural , Lactobacillus fermentum , Mastite , Abscesso/etiologia , Abscesso/terapia , Aleitamento Materno , Empiema Pleural/complicações , Feminino , Seguimentos , Humanos , Lactação/fisiologia , Mastite/terapia
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