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Mycoses Nov 2023Out of the context of haematological patients, Candida sp. is rarely retrieved from pyogenic liver abscesses (PLA).
BACKGROUND
Out of the context of haematological patients, Candida sp. is rarely retrieved from pyogenic liver abscesses (PLA).
OBJECTIVES
Our objective was to assess the risk factors for occurrence, and clinical, microbiological characteristics, management and outcome of Candida pyogenic liver abscesses (C-PLA).
PATIENTS/METHODS
We retrospectively analysed C-PLA cases and compared them to pyogenic liver abscesses exclusively due to bacteria (B-PLA) included in our monocentric database on liver abscesses. Unfavourable course was defined as the occurrence of a primary treatment failure (PTF), recurrence after an initial cure, or death within 3 months after diagnosis.
RESULTS
Between 2010 and 2018, 15 C-PLA and 292 B-PLA were included. All C-PLA had a biliary origin and were polymicrobial. All patients with C-PLA had at least one comorbidity at risk for Candida infection and 7 (53.3%) presented with sepsis requiring an admission in intensive care unit. Median duration of antifungal treatment was 42 days [24-55]. In multivariate analysis, compared with B-PLA, a medical history of malignancy (OR 4.16; 95%CI 1.15-18.72) or liver abscess (OR 7.39; 95%CI 2.10-26.62), and sepsis with severity criteria (OR 3.52; 95%CI 1.07-11.90) were independently associated with the occurrence of C-PLA. In multivariate analysis, C-PLA was associated with a higher risk of recurrence (HR 3.08; 95%CI 1.38-11.22).
CONCLUSION
Candida liver abscesses in non-neutropenic is a rare and severe disease. The high rate of recurrence should lead to discuss a more intensive treatment.
Topics: Humans; Liver Abscess, Pyogenic; Retrospective Studies; Treatment Outcome; Sepsis; Polyesters
PubMed: 37534436
DOI: 10.1111/myc.13636 -
Pediatric Emergency Care Dec 2021Pilomatrixomas, also known as epithelioma calcificans, are benign tumors of hair follicle matrix cells that are often mistaken for other lesions, especially cutaneous...
Pilomatrixomas, also known as epithelioma calcificans, are benign tumors of hair follicle matrix cells that are often mistaken for other lesions, especially cutaneous abscesses. We report an illustrative case in which a teenage girl developed a red, swollen earlobe that required multiple care visits and interventions until definitive diagnosis and treatment were provided. Although the lesion was initially treated as an abscess, it continued to progress in size and discomfort. The correct diagnosis was established after imaging and complete excision with pathologic examination. Ultimately, our patient was subjected to avoidable procedures that carried the risk of potentially negative cosmetic sequelae before the proper intervention. Although abscesses are common, it is important for clinicians to avoid incision and drainage of lesions, unless the diagnosis is certain.
Topics: Abscess; Adolescent; Drainage; Female; Humans; Skin Diseases
PubMed: 30907848
DOI: 10.1097/PEC.0000000000001809 -
Revista Espanola de Enfermedades... May 2023A 50-year-old male, with a medical history of Lynch syndrome and transurethral-resection (TUR) secondary to multifocal bladder tumour (pT1-high grade) with normal...
A 50-year-old male, with a medical history of Lynch syndrome and transurethral-resection (TUR) secondary to multifocal bladder tumour (pT1-high grade) with normal subsequent follow-ups, consulted for anal pain, rectal tenesmus and fever for 3 weeks. On examination, he presented perianal oedema and, on digital rectal examination, a right lateral orifice was palpable at 6cm from the anal margin. CT scan revealed a defect-in-continuity in the right rectal wall which communicated with bilateral perirectal collections extending towards the puborectalis-levator ani. On the right side, it extended towards the ischiorectal fossa and, on the left side it continued with another collection that displaced the corpus cavernosum. Urgent transanal debridement of abscess with biopsy and cultures was performed. Subsequent evolution was torpid. The clinical history was reviewed, as the patient had undergone repeated bladder catheterizations after TUR and BCG therapy one year before. Abdominal tomography with urethral contrast and cystourethrography were performed, which confirmed the presence of a fistula in the bulbomembranous urethra that communicated with the perirectal abscesses. Cultures and biopsies were negative for mycobacteria and malignancy was ruled out. A new surgical exploration was carried out, enlarging the transanal drainage orifice, making a temporary intestinal stoma and bladder catheterization. After eighteen weeks, the healing of the fistula was verified through of a new cystourethrography. Reconstruction of the intestinal transit has now been scheduled, after radiologically and endoscopically verifying the closure of the rectal orifice.
Topics: Male; Humans; Middle Aged; Abscess; Urethra; Rectal Diseases; Rectum; Fistula
PubMed: 36695767
DOI: 10.17235/reed.2023.9456/2023 -
International Journal of Pediatric... Dec 2019To review a single-surgeon, 16-year experience with the management of infected preauricular sinuses/cysts.
OBJECTIVE
To review a single-surgeon, 16-year experience with the management of infected preauricular sinuses/cysts.
METHODS
Computerized search of all office notes and operative reports during the years 2002-2018.
SETTING
Academic medical center and suburban office practice.
PARTICIPANTS
Children from 0 to 18 years of age with symptomatic preauricular sinuses/cysts.
INTERVENTION
Children with symptomatic preauricular sinuses/cysts underwent surgical excision. Those presenting with infected cysts were treated with oral antibiotics, needle-aspiration and/or incision and drainage to control infection prior to surgery. The chronic preauricular abscesses were curetted without resection of overlying skin or the abscess walls.
MAIN OUTCOME MEASURE
Control of infection without recurrence following surgery.
RESULTS
415 patient encounters involved preauricular sinuses/cysts. These ultimately led to 56 surgical excisions. 28 of the sinuses/cysts were infected at presentation. All infected lesions were treated with oral antibiotics. 6 infected sinuses/cysts were needle aspirated. 2 infected sinuses/cysts required incision and drainage. 1 infected sinus/cyst could not be controlled by either drainage technique and was surgically excised while actively infected. Nine children presented with chronic preauricular abscesses. One the 28 infected sinuses/cysts (3.5%) recurred 10 years after surgery- it was cured with re-resection at the root of the helix.
CONCLUSION
Treatment of infected preauricular sinuses/cysts remains controversial. Control of infection prior to definitive surgery is desirable, but not mandatory. Chronic preauricular abscesses can be managed by sinus/cyst excision and subcutaneous abscess curettage without resection of the abscess wall or overlying skin. This leads to consistent control and favorable cosmesis.
Topics: Abscess; Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Craniofacial Abnormalities; Cysts; Drainage; Humans; Infant; Infant, Newborn; Recurrence
PubMed: 31546061
DOI: 10.1016/j.ijporl.2019.109682 -
Acta Otorrinolaringologica Espanola 2019Thyroid abscess or acute suppurative thyroiditis is an unusual clinical condition. We present our experience with cases attended over 41 years.
BACKGROUND
Thyroid abscess or acute suppurative thyroiditis is an unusual clinical condition. We present our experience with cases attended over 41 years.
MATERIALS AND METHODS
A retrospective study was performed on these patients reviewing their epidemiological characteristics and the diagnostic and therapeutic manoeuvres chosen for them all, as well as their clinical outcome. A group of 9 males and 5 females was studied, with ages ranging from 19 to 68 (mean of 40.6±15.4). These patients suffered 22 acute episodes, and 2 patients each had 4 episodes.
RESULTS
Suppurative thyroiditis comprised 0.29% of the neck abscesses. Fine needle aspiration was performed in 13 cases to evacuate the collection and isolate the aetiological agent. Mycobacterium tuberculosis and Staphylococcus aureus were the most frequently identified. Nine patients underwent ultrasound and 7 computed tomography imaging studies. Surgery was the option for 10 patients, including drainage for 7, thyroidectomy for 4 and hemithyroidectomy for the remaining 2. Systemic or intralesional antibiotics and sclerosis of the gland were also carried out. Although one case presented with hyperthyroidism and thyrotoxicosis in the acute phase, definitive hypothyroidism was observed in 5 patients at 6 months following discharge. The rate of success was 100%.
CONCLUSION
Thyroid gland suppuration is a very infrequent circumstance in neck pathology, and the options for its treatment are varied, from conservative to invasive techniques according to the microbial and radiologic findings.
Topics: Abscess; Acute Disease; Adult; Aged; Anti-Bacterial Agents; Drainage; Female; Humans; Male; Middle Aged; Retrospective Studies; Therapeutic Irrigation; Thyroid Diseases; Thyroidectomy; Thyroiditis, Suppurative; Young Adult
PubMed: 29891396
DOI: 10.1016/j.otorri.2018.01.005 -
Zhonghua Jie He He Hu Xi Za Zhi =... May 2022To study the clinical and microbiological characteristics of hypervirulent (hvKP) lung abscess, and to compare with the classic (cKP) lung abscess. A total of 18...
To study the clinical and microbiological characteristics of hypervirulent (hvKP) lung abscess, and to compare with the classic (cKP) lung abscess. A total of 18 patients with lung abscesses admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from January 2017 to September 2020 enrolled. The strains with positive result of string test were defined as hvKP, and the negative strains were defined as cKP. The patients' basic diseases, symptoms, laboratory data and other clinical characteristics were collected. The microbiological characteristics of the strains included as following: VITEK method to determine the susceptibility of the strains to antibiotics; PCR to detect the capsular serotypes and virulence genes. The differences in clinical characteristics and microbiological characteristics of strains between hvKP group and cKP group were compared. Among the 18 patients with lung abscess, 12 were hvKP infection, mainly male (10 cases), with a median age of 59.0 years; 8 cases in the hvKP group had an onset time of ≤2 weeks, and the median onset time was 10.5 days. There were significantly more diabetes (12 cases) and extrapulmonary abscesses (11 cases) in hvKP group than those in cKP group (both <0.001). The extrapulmonary abscesses in the hvKP group were mainly liver abscesses (10 cases), and 4 cases were multi-site (≥3) abscesses. The number of indwelling catheters and invasive procedures before infection were higher in cKP group than those in hvKP group (both =0.025). The imaging of lung abscess was mainly subpleural with the size of less than 10 cm. There were more multiple abscesses cases in hvKP group (9 cases) than cKP group (=0.009). The median interval time between the detection of a pulmonary abscess and an extrapulmonary abscess was 1.0 day. The resistance rate of common antibiotics was significantly lower in hvKP than cKP. hvKP lung abscesses are more common in patients with diabetes, and the clinical manifestations are nonspecific. The lung imaging manifestations are multiple subpleural abscesses, indicating hematogenous dissemination. Liver abscesses were present in most cases, suggesting the source of infection. The main virulent gene of hypervirulent is . For patients with hvKP lung abscess, attention should be paid to finding hidden lesions.
Topics: Anti-Bacterial Agents; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver Abscess; Lung Abscess; Male; Middle Aged; Pneumonia
PubMed: 35527458
DOI: 10.3760/cma.j.cn112147-20210820-00580 -
The Annals of Otology, Rhinology, and... Aug 2023Laryngeal abscesses are rare in the modern antibiotic era. Historically, they were associated with systemic infections including typhoid fever, measles, gonorrhea,... (Review)
Review
OBJECTIVE
Laryngeal abscesses are rare in the modern antibiotic era. Historically, they were associated with systemic infections including typhoid fever, measles, gonorrhea, syphilis, and tuberculosis. More recent authors have described cases resulting from iatrogenic injury and immunosuppression. This report presents a novel case of laryngeal abscess in the setting of uncontrolled diabetes and a detailed review of modern, reported cases of spontaneous laryngeal abscess.
METHODS
Report of a single case. Also, PubMed was queried for cases of laryngeal abscess since 1985.
CASE REPORT
A 58-year-old male with poorly controlled diabetes presented with odynophagia, dysphagia, and dyspnea. He had biphasic stridor, and flexible laryngoscopy showed reduced mobility of bilateral vocal folds and narrowed glottic airway. He was taken urgently for awake tracheostomy and microdirect laryngoscopy. Laryngoscopy demonstrated fullness and fluctuance of the right hemilarynx. The abscess cavity was entered endoscopically via paraglottic incision extending into the subglottis. The patient was treated with an 8-week course of ampicillin-sulbactam with resolution of infection.
RESULTS
Seven additional cases of spontaneous laryngeal abscesses published after 1985 were identified. In total, 6 of 8 had some form of immunodeficiency (75%). The most common presenting symptoms were dysphonia (8/8, 100%), odynophagia (5/8, 62.5%), and dyspnea/stridor (4/8, 50%). All cases were treated with surgical incision and drainage.
CONCLUSIONS
Laryngeal abscesses are rare in the era of modern antibiotics. This review confirms that the majority of recent episodes occurred in the setting of immunodeficiency and are caused by non-tubercular bacteria. These infections are commonly associated with impaired vocal fold mobility which may contribute to dyspnea, stridor, and airway compromise. Surgical intervention is necessary for treatment and culture-directed antimicrobial therapy. Poorly controlled diabetes is a newly described context for development of spontaneous laryngeal abscess.
Topics: Male; Humans; Middle Aged; Abscess; Respiratory Sounds; Vocal Cords; Laryngoscopy; Anti-Bacterial Agents; Dyspnea
PubMed: 35923122
DOI: 10.1177/00034894221115757 -
The Veterinary Clinics of North... Nov 2022For more than 80 years, liver abscesses have been documented to reduce beef system value. These infections of liver tissue result in poorer growth performance as... (Review)
Review
For more than 80 years, liver abscesses have been documented to reduce beef system value. These infections of liver tissue result in poorer growth performance as evidenced by diminished live and carcass weights, leaner and lesser muscled carcasses, and greater rates of trim. Those negative outcomes are compounded by reduced animal and carcass value. As technology advances, methods to reduce and prevent liver abscesses should be a goal of scientists and producers worldwide.
Topics: Animals; Body Composition; Cattle; Cattle Diseases; Liver Abscess; Meat
PubMed: 36243458
DOI: 10.1016/j.cvfa.2022.08.003 -
The Medical Journal of Malaysia Mar 2021Melioidosis is endemic in the State of Sabah, Malaysia. We report a case of a 34-year-old man with one-week history of fever and cough, three days history of diarrhoea...
Melioidosis is endemic in the State of Sabah, Malaysia. We report a case of a 34-year-old man with one-week history of fever and cough, three days history of diarrhoea and vomiting, which was associated with a loss of appetite and loss of weight for one-month. Clinically, he had hepatosplenomegaly and crepitation over his right lower zone of lung. Chest radiograph showed right lower lobe consolidation. Ultrasound abdomen showed liver and splenic abscesses. Ultrasound guided drainage of splenic abscess yielded Burkholderia pseudomallei. Magnetic resonance imaging (MRI) lumbosacral confirmed right sacral intraosseous abscess after he developed back pain a week later. He received 6 weeks of intravenous antibiotics and oral co-trimoxazole, followed by 6 months oral co-trimoxazole and had full recovery.
Topics: Abscess; Adult; Anti-Bacterial Agents; Burkholderia pseudomallei; Humans; Male; Melioidosis; Splenic Diseases; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 33742639
DOI: No ID Found -
Pediatric Surgery International Oct 2023
Topics: Humans; Abscess; Anus Diseases; Rectal Fistula
PubMed: 37801089
DOI: 10.1007/s00383-023-05563-2