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German Medical Science : GMS E-journal 2022Pyometra is a rare gynecological condition and is characterized by pus accumulation in the uterine cavity. It occurs more frequently in postmenopausal women than...
BACKGROUND
Pyometra is a rare gynecological condition and is characterized by pus accumulation in the uterine cavity. It occurs more frequently in postmenopausal women than tubo-ovarian abscesses, which constitute a more common gynecological complication among premenopausal women.
OBJECTIVE
A 72-year-old woman was admitted to our emergency department with lower abdominal pain, diarrhea and fever for the last three days. The laboratory results were indicative to sepsis. The clinical examination revealed sensitivity by palpation of the lower abdomen without any signs of acute abdomen. The gynecological assessment showed pus outflow through the cervix and a pus culture was done. The ultrasound examination found an enlarged uterus, full of hypoechoic fluid, unclear borders between endometrium-myometrium, a mixed echogenicity adnexal mass and no free fluid in the pouch of Douglas. A computed tomography (CT) of the abdomen showed the presence of pyometra and a tubo-ovarian abscess of the right adnexa.
METHOD
The patient was treated with intravenous antibiotic therapy. When the patient was hemodynamically stable and afebrile, she underwent ultrasound-guided dilatation and curettage of the cervical canal and the endometrium in order to exclude an underlying malignancy, under general anesthesia.
RESULTS
The patient responded promptly to the intravenous antibiotic therapy which was adapted to the pus culture result. The laboratory results withdrew to normal values and the patient was discharged after fifteen days of hospitalization in an afebrile and hemodynamically stable condition.
CONCLUSION
Pyometra and tubo-ovarian abscess in postmenopausal women could be a lethal complication of pelvic inflammatory disease. The key in treatment is the dilatation of the cervix and drainage of the pyometra. The administration of intravenous antibiotics and drainage through the cervix could be a suitable method of treatment for pyometra in older patients or those with poor performance status if only the histological examination is negative for malignancy.
Topics: Abdominal Abscess; Abscess; Aged; Anti-Bacterial Agents; Female; Humans; Oophoritis; Postmenopause; Pyometra; Salpingitis
PubMed: 35875245
DOI: 10.3205/000311 -
Annals of the Royal College of Surgeons... Oct 2021Ectopic ovary is a rare gynaecological condition that results in problems with menstruation and pregnancy and may develop into a malignant tumour. However, as the...
Ectopic ovary is a rare gynaecological condition that results in problems with menstruation and pregnancy and may develop into a malignant tumour. However, as the condition is often asymptomatic, diagnosis is difficult and frequently delayed. We report a case of a 42-year-old female who presented with a 10-day history of abdominal pain. The patient underwent surgery that confirmed the diagnosis of an ectopic ovary with an internal abscess. The findings of our study indicate that ectopic ovaries can present with an abscess. Ectopic ovaries should be included in the differential diagnosis of masses with internal abscesses.
Topics: Abscess; Adult; Female; Humans; Mesentery; Ovary; Peritoneal Diseases
PubMed: 34414779
DOI: 10.1308/rcsann.2021.0032 -
Health & Social Care in the Community Sep 2022Skin and soft tissue infections (SSTIs) are the most common medical complication of injection drug use in the United States, though little work has been done assessing...
Skin and soft tissue infections (SSTIs) are the most common medical complication of injection drug use in the United States, though little work has been done assessing SSTI treatment among people who inject drugs (PWID). We examined past-3-month abscess characteristics, treatment utilization, and barriers to medical treatment among N = 494 community-recruited PWID. We used descriptive statistics to determine the frequencies of self-treatment and medical treatment for their most recent past-3-month abscess as well as barriers to seeking medical treatment. We then used bivariate and multivariate logistic regression to identify factors associated with having an abscess in the past 3 months. Overall, 67% of participating PWID ever had an abscess and 23% had one in the past 3 months. Only 29% got medical treatment for their most recent abscess whereas 79% self-treated. Methods for self-treatment included pressing the pus out (81%), applying a hot compress (79%), and applying hydrogen peroxide (67%). Most (91%) self-treated abscesses healed without further intervention. Barriers to medical treatment included long wait times (56%), being afraid to go (49%), and not wanting to be identified as a PWID (46%). Factors associated independently with having an abscess in the past 3 months were injecting purposely into muscle tissue (adjusted odds ratio [AOR] = 2.64), having difficulty finding a vein (AOR = 2.08), and sharing injection preparation equipment (AOR = 1.74). Our findings emphasize the importance of expanding community-based access to SSTI education and treatment services, particularly at syringe service programs where PWID may be more comfortable seeking resources.
Topics: Abscess; Drug Users; HIV Infections; Humans; Self Care; Soft Tissue Infections; Substance Abuse, Intravenous; United States
PubMed: 34469034
DOI: 10.1111/hsc.13559 -
Revista Espanola de Enfermedades... Jan 2023A 70-year-old male with a large abscessed GIST is reported. Symptoms, laboratory results, diagnostic imaging and surgical field information are provided. It is a rare...
A 70-year-old male with a large abscessed GIST is reported. Symptoms, laboratory results, diagnostic imaging and surgical field information are provided. It is a rare initial presentation of a GIST which we believe to be academically interesting.
Topics: Aged; Humans; Male; Abscess; Gastrointestinal Stromal Tumors; Gastrointestinal Neoplasms
PubMed: 35255697
DOI: 10.17235/reed.2022.8580/2022 -
Academic Emergency Medicine : Official... Mar 2021Cutaneous abscesses are common presentations to the emergency department. While the primary treatment for most abscesses is conventional incision and drainage (CID),... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Cutaneous abscesses are common presentations to the emergency department. While the primary treatment for most abscesses is conventional incision and drainage (CID), this is painful and can lead to multiple return visits. The loop drainage technique (LDT) has been proposed as an alternate, less-invasive approach to abscess management. The primary outcome of this study was to compare LDT with CID for skin and soft tissue abscesses.
METHODS
PubMed, Scopus, CINAHL, LILACS, Google Scholar, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all retrospective, prospective observational, and randomized controlled trials comparing treatment failures between LDT and CID among patients with skin and soft tissue abscesses. Data were dual extracted into a predefined worksheet and quality analysis was performed using the Cochrane Risk of Bias tool or the Newcastle-Ottawa scale. Data were summarized and presented as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses were performed for adult and pediatric patients.
RESULTS
A total of 1,374 studies were identified with eight studies (n = 910 patients) selected for inclusion. Overall, CID failed in 69 of 487 patients (14.17%), while LDT failed in 35 of 423 patients (8.27%). There was an OR of 2.02 (95% CI = 1.29 to 3.18) in favor of higher failures in the CID group. This finding remained consistent with only randomized controlled trials (OR = 1.75, 95% CI = 1.07 to 2.86), but no difference was identified in the adult or pediatric subgroups.
CONCLUSION
The LDT was associated with reduced treatment failures when compared with CID. Future studies should further assess the impact on pain, cosmetic outcomes, and health care costs.
Topics: Abscess; Adult; Child; Drainage; Humans; Observational Studies as Topic; Retrospective Studies; Skin Diseases; Treatment Failure
PubMed: 33037713
DOI: 10.1111/acem.14151 -
Revista Da Sociedade Brasileira de... 2023
Topics: Humans; Abscess; Melioidosis; Sternoclavicular Joint
PubMed: 36995784
DOI: 10.1590/0037-8682-0033-2023 -
Revista Da Sociedade Brasileira de... 2023
Topics: Humans; Melioidosis; Abscess; Splenic Diseases; Sepsis
PubMed: 37792846
DOI: 10.1590/0037-8682-0394-2023 -
Acta Gastro-enterologica Belgica 2015Diverticulosis of the colon is a common disease with an increasing incidence in Western countries. Recent literature has shown some changes in the traditional approach... (Review)
Review
Diverticulosis of the colon is a common disease with an increasing incidence in Western countries. Recent literature has shown some changes in the traditional approach of this disease. The theory that diverticulosis is caused by a reduced intake of dietary fibre, is doubtful. There might be some chemical and histological overlap between diverticulitis, inflammatory bowel disease and irritable bowel disease. High quality clinical study found no effect for antibiotics in acute, uncomplicated diverticulitis. Cyclic administration of mesalazine and rifaximin result in reduced symptoms of diverticular disease. For the treatment of diverticular abscesses, percutaneous drainage shows promising results. Recurrence of acute diverticulitis is rare and most serious complications are linked to the first episode. Recent evidence does not support the traditional recommendation for elective surgery after two episodes of acute diverticulitis any more. This review summarizes the last evidence in diverticular disease and diverticulitis.
Topics: Abscess; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Dietary Fiber; Diverticulitis; Drainage; Gastrointestinal Agents; Humans; Inflammatory Bowel Diseases; Irritable Bowel Syndrome; Mesalamine; Rifamycins; Rifaximin
PubMed: 26118576
DOI: No ID Found -
The American Journal of Case Reports Dec 2023BACKGROUND Fish bone ingestion is the most common cause of esophageal perforation (12%). However, it rarely causes esophageal perforation and mediastinal abscess. Most... (Review)
Review
BACKGROUND Fish bone ingestion is the most common cause of esophageal perforation (12%). However, it rarely causes esophageal perforation and mediastinal abscess. Most studies recommend surgical intervention for patients with esophageal perforation and thoracic abscess. However, surgery may not be suitable for extremely critical cases or may have limited effectiveness. In such cases, a combination of surgery and conservative treatment is crucial. The use of double cannula irrigation and drainage in conservative treatment has shown promising results in pus removal. CASE REPORT We report a 28-year-old man with a perforated esophagus with abscess and mediastinal abscess due to fish bone. Emergency surgery was performed after admission. Symptoms of septic shock developed after surgery, and a significant amount of pus was still present in the chest cavity and mediastinum. Conservative treatment was adopted, with double cannula irrigation and drainage. By employing anti-infection measures and continuous irrigation and drainage, the patient was cured after 42 days. CONCLUSIONS In this case, surgical intervention did not yield satisfactory results. However, after using double cannula irrigation and drainage to clear the thoracic and mediastinal abscesses, the patient's infection levels returned to normal. Additionally, the patient was successfully weaned off the ventilator, and the tracheotomy catheter was removed. After discharge, the patient resumed to normal life, without any significant complications during 1 year of follow-up. Double cannula drainage played a vital role in this patient's treatment; however, further clinical evidence is required to determine its suitability for other patients with esophageal perforation complicated by mediastinal abscess.
Topics: Male; Animals; Humans; Adult; Esophageal Perforation; Abscess; Mediastinal Diseases; Drainage; Conservative Treatment
PubMed: 38105546
DOI: 10.12659/AJCR.942056 -
Medicina (Kaunas, Lithuania) Sep 2022Aseptic abscess syndrome (AAS) is a rare, potentially life-threatening disorder, with numerous features of neutrophilic dermatoses. The main symptoms include aseptic...
Aseptic abscess syndrome (AAS) is a rare, potentially life-threatening disorder, with numerous features of neutrophilic dermatoses. The main symptoms include aseptic abscess-like collections in internal organs (spleen, liver, lungs), lack of microbes (bacteria, viruses, or parasites) after an exhaustive search, ineffectiveness of antibiotics, and high sensitivity to corticosteroid therapy. AAS is characterized by the development of deep, inflammatory abscesses and systemic symptoms (weight loss, abdominal pain, fever, and leukocytosis). They may be associated with inflammatory bowel disease (IBD) and autoimmune diseases. The patient in this study is a 67-year-old man, suffering from rheumatoid arthritis (RA), with numerous purulent abscesses in the mediastinum, within the subcutaneous tissue above the extension surfaces of the joints, and on the dorsum of the hands. The lesions are accompanied by bone destruction. The patient was treated with prednisone 40 mg and adalimumab, which resulted in a quick reduction of inflammatory markers and clinical improvement, as well as the healing and absorption of abscesses. Despite COVID-19 infection, treatment with remdesivir, prednisone, and adalimumab was continued, with the complete resolution of the lesions. AAS is difficult to recognize, so practitioners have to be aware of this condition, especially in patients with RA.
Topics: Male; Humans; Aged; Abscess; Prednisone; Adalimumab; COVID-19; Arthritis, Rheumatoid; Syndrome; Anti-Bacterial Agents; Adrenal Cortex Hormones
PubMed: 36295515
DOI: 10.3390/medicina58101354