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European Journal of Dermatology : EJD Apr 2024
Topics: Humans; Hidradenitis Suppurativa; Adalimumab; Wound Healing; Anti-Inflammatory Agents; Adult; Female; Male
PubMed: 38907552
DOI: 10.1684/ejd.2024.4650 -
Medicine Jun 2024Acute epiglottitis is not uncommon and it can cause high mortality due to airway obstruction. Acute epiglottitis complicated with cervical necrotizing fasciitis has...
INTRODUCTION
Acute epiglottitis is not uncommon and it can cause high mortality due to airway obstruction. Acute epiglottitis complicated with cervical necrotizing fasciitis has rarely been reported, and it is also a life-threatening disease with a fatality rate of 7% to 50%.
PATIENT CONCERNS
A 64-year-old woman presented to our hospital with chief complaints of sore throat and cervical swelling, long with foreign body sensation and hoarseness. Endoscopic laryngoscopy showed erythematous and swollen epiglottis with purulent secretions on the surface. Computed tomography (CT) scan showed swollen epiglottis and swelling of the neck with air- and fluid-containing necrotizing tissue.
DIAGNOSES
The diagnosis was acute epiglottitis and abscess complicated with cervical necrotizing fasciitis.
INTERVENTIONS
With the patient in awake condition, airway access was established by performing intubation with adjunctive use of gum elastic bougie, followed by surgical debridement under general anesthesia; a flap was used for skin coverage and intravenous piperacillin-tazobactam was administered.
OUTCOMES
The patient was discharged without complications.
CONCLUSION
Gum elastic bougie is a usable tool in difficult intubation. Adequate pre-anesthesia evaluation, patient sedation, and gentle manipulation assured the intubation success in this case.
Topics: Humans; Female; Fasciitis, Necrotizing; Middle Aged; Epiglottitis; Intubation, Intratracheal; Abscess; Acute Disease; Neck; Debridement; Laryngoscopy; Anti-Bacterial Agents; Tomography, X-Ray Computed
PubMed: 38905392
DOI: 10.1097/MD.0000000000038658 -
Archives of Dermatological Research Jun 2024
Association between viral control and severity of hidradenitis suppurativa in a cohort of patients with comorbid human immunodeficiency virus and hidradenitis suppurativa.
Topics: Humans; Hidradenitis Suppurativa; HIV Infections; Male; Female; Severity of Illness Index; Adult; Middle Aged; Comorbidity; Viral Load; Coinfection
PubMed: 38904685
DOI: 10.1007/s00403-024-03171-1 -
Clinical Journal of Gastroenterology Jun 2024Acute obstructive suppurative pancreatic ductitis (AOSPD) is an acute suppuration of the pancreatic duct. Endoscopic retrograde cholangiopancreatography (ERCP) drainage...
Acute obstructive suppurative pancreatic ductitis (AOSPD) is an acute suppuration of the pancreatic duct. Endoscopic retrograde cholangiopancreatography (ERCP) drainage and intravenous antibiotics treatment is the mainstay of therapy. Herein we describe an extremely rare case of AOSPD leading to pyogenic spondylitis. A 61-year-old male with a past medical history of chronic pancreatitis and diabetes mellitus presented to our hospital with abdominal and dorsal pain, fever, and shock status. Laboratory data showed severe inflammation, disseminated intravascular coagulation, and normal pancreatic enzymes. Computed tomography showed dilated main pancreatic duct and surrounding pancreatic abscesses. Spinal abnormalities were not detected at this point. He was initially diagnosed as infected pancreatic pseudocyst, but did not respond well to conservative intravenous antibiotic treatment. ERCP performed one week later revealed purulent pancreatic juice and the diagnosis was changed to AOSPD. Upon ERCP, we experienced technical difficulty in passing obstructing calculi. However, successful pancreatic drainage was achieved using new dilation and penetration devices. The patient responded quickly to drainage, but later developed pyogenic spondylitis. Our case highlights the difficulty of diagnosing AOSPD, the usefulness of new devices in urgent endoscopic drainage, and underscores the possibility of progression of pyogenic spondylitis even after adequate treatment.
PubMed: 38902593
DOI: 10.1007/s12328-024-02004-y -
The New Zealand Medical Journal Jun 2024
Thoracic Society of Australia and New Zealand position statement on chronic suppurative lung disease and bronchiectasis in children, adolescents and adults: what is new and relevant to Aotearoa New Zealand?
Topics: Humans; Bronchiectasis; New Zealand; Adolescent; Child; Adult; Australia; Societies, Medical; Chronic Disease; Lung Diseases; Suppuration; Practice Guidelines as Topic
PubMed: 38901044
DOI: 10.26635/6965.e1597 -
Compendium of Continuing Education in... May 2024The objective of this case study is to report on the diagnosis and treatment of medication-related osteonecrosis of the jaw (MRONJ), which was originally misdiagnosed...
The objective of this case study is to report on the diagnosis and treatment of medication-related osteonecrosis of the jaw (MRONJ), which was originally misdiagnosed and mistreated as endodontic disease. A patient was referred for worsening odontalgia despite root canal therapy on tooth No. 19 and a course of oral antibiotics. Examination demonstrated slight buccal swelling and tenderness in the left masseter and a 7-mm diameter area of exposed bone on the mandibular left lingual torus. Further history-taking revealed prior bisphosphonate therapy for metastatic breast cancer. MRONJ was identified as the likely diagnosis, and the patient was appropriately referred to oral and maxillofacial surgery where the diagnosis was confirmed and surgical debridement performed. The case study demonstrates how the symptomatology and presentation of MRONJ can resemble endodontic disease and that timely and appropriate treatment requires eliciting an in-depth medical history, reaching a complete pulpal and periapical diagnosis, and remaining attentive to the presence of exposed bone on examination.
Topics: Humans; Female; Bisphosphonate-Associated Osteonecrosis of the Jaw; Periapical Abscess; Diagnostic Errors; Diagnosis, Differential; Breast Neoplasms; Middle Aged
PubMed: 38900463
DOI: No ID Found -
World Journal of Clinical Cases Jun 2024Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). The complications of TACE include biliary tract...
BACKGROUND
Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). The complications of TACE include biliary tract infection, liver dysfunction, tumor lysis syndrome, biloma, partial intestinal obstruction, cerebral lipiodol embolism, . There are few reports about tracheal fistula induced by TACE.
CASE SUMMARY
A 42-year-old man came to our hospital with cough and expectoration for 1 month after TACE for HCC. Laboratory test results showed abnormalities of albumin, hemoglobin, prothrombin time, C-reactive protein, D-dimer, and prothrombin. Culture of both phlegm and liver pus revealed growth of . Computed tomography showed infection in the inferior lobe of the right lung and a low-density lesion with gas in the right liver. Liver ultrasound showed that there was a big hypoechoic liquid lesion without blood flow signal. Drainage for liver abscess by needle puncture under ultrasonic guidance was performed. After 1 month of drainage and anti-infection therapy, the abscess in the liver and the infection in the lung were reduced obviously, and the symptom of expectoration was relieved.
CONCLUSION
Clinicians should be alert to the possibility of complications of liver abscess and tracheal fistula after TACE for HCC. Drainage for liver abscess by needle puncture under ultrasonic guidance could relieve the liver abscess and tracheal fistula.
PubMed: 38899298
DOI: 10.12998/wjcc.v12.i16.2911 -
World Journal of Clinical Cases Jun 2024This case series investigated the clinical manifestations, diagnoses, and treatment of cerebral abscesses caused by . We retrospectively analyzed the clinical...
BACKGROUND
This case series investigated the clinical manifestations, diagnoses, and treatment of cerebral abscesses caused by . We retrospectively analyzed the clinical characteristics and outcomes of three cases of cerebral abscesses caused by and conducted a comprehensive review of relevant literature.
CASE SUMMARY
Case 1 presented with a history of left otitis media and exhibited high fever, confusion, and vomiting as primary symptoms. Postoperative pus culture indicated a brain abscess caused by infection. Case 2 experienced dizziness for two days as the primary symptom. Postoperative pus culture suggested an intermediate streptococcal brain abscess. Case 3: Enhanced head magnetic resonance imaging (MRI) and diffusion-weighted imaging revealed occupancy of the left temporal lobe, initially suspected to be a metastatic tumor. However, a postoperative pus culture confirmed the presence of a brain abscess caused by infection. The three cases presented in this case series were all patients with community-acquired brain abscesses resulting from angina caused by Streptococcus group infection. All three patients demonstrated sensitivity to penicillin, ceftriaxone, vancomycin, linezolid, chloramphenicol, and levofloxacin. Successful treatment was achieved through stereotaxic puncture, drainage, and ceftriaxone administration with a six -week course of antibiotics.
CONCLUSION
Preoperative enhanced head MRI plays a critical role in distinguishing brain tumors from abscesses. Selecting the correct early diagnostic methods for brain abscesses and providing timely intervention are very important. This case series was in accordance with the CARE guidelines.
PubMed: 38898852
DOI: 10.12998/wjcc.v12.i17.3243 -
BMC Infectious Diseases Jun 2024Cutibacterium acnes is an anaerobic bacterium mostly implicated in cutaneous and body-implant infections. Splenic abscess is a rare entity and C. acnes abscesses have...
BACKGROUND
Cutibacterium acnes is an anaerobic bacterium mostly implicated in cutaneous and body-implant infections. Splenic abscess is a rare entity and C. acnes abscesses have only exceptionally been reported. We describe a spontaneous splenic C. acnes abscess in an immunocompetent man with no predisposing factors or identified portal of entry. His isolates were subjected to single-locus sequence typing (SLST) to explore their genetic relatedness and better understand this rare infection.
CASE PRESENTATION
A splenic abscess was diagnosed on a computed-tomography scan in a 74-year-old man with chronic abdominal pain. No risk factor was identified. Abscess-drained pus and post-drainage blood cultures grew C. acnes. SLST of abscess and blood isolates showed that they belonged to the same C. acnes SLST type C1 found in normal skin and rarely in inflammatory skin disease. Specific virulence factors could not be identified.
CONCLUSION
C. acnes abscesses are extremely rare and can develop in immunocompetent patients without an identifiable portal of entry. Molecular typing of clinical isolates can help confirm infection (versus contamination) and enables genetic background comparisons. Further research is needed to understand C. acnes tropism and virulence.
Topics: Humans; Male; Aged; Bacteremia; Splenic Diseases; Gram-Positive Bacterial Infections; Abscess; Phylogeny; Immunocompetence; Tomography, X-Ray Computed
PubMed: 38898385
DOI: 10.1186/s12879-024-09467-x -
FP Essentials Jun 2024Bacterial skin infections represent a significant health care burden. Cellulitis and erysipelas are rapidly spreading, painful, superficial skin infections, usually... (Review)
Review
Bacterial skin infections represent a significant health care burden. Cellulitis and erysipelas are rapidly spreading, painful, superficial skin infections, usually caused by streptococci or . Folliculitis is an infection of hair follicles mostly caused by . Simple folliculitis typically is self-limited. Topical benzoyl peroxide is a first-line nonantibiotic treatment. Mupirocin and clindamycin are topical antibiotic options. For treatment-resistant cases, oral cephalexin or dicloxacillin is an appropriate option. Impetigo is a common, self-limited infection in children. Bullous impetigo is caused by , and nonbullous impetigo is caused by beta-hemolytic streptococci, , or both. In most cases, topical mupirocin or retapamulin (Altabax) is effective. Oral antibiotics should be considered for household outbreaks or patients with multiple lesions. Abscesses are red, painful collections of purulence in the dermis and deeper tissues caused by or polymicrobial infections. Furuncles are abscesses of a hair follicle, whereas carbuncles involve several hair follicles. In recurrent cases of these lesions, culture of the exudate is recommended. Abscess, furuncle, and carbuncle management consists of incision and drainage. Oral antibiotics are not necessary in most cases but should be prescribed for patients with severe immunocompromise or systemic signs of infection. In bacterial skin infections, methicillin-resistant coverage should be considered for patients with infections that have not improved with treatment.
Topics: Humans; Child; Anti-Bacterial Agents; Adolescent; Impetigo; Skin Diseases, Bacterial; Cellulitis; Folliculitis; Erysipelas; Abscess; Furunculosis; Carbuncle
PubMed: 38896826
DOI: No ID Found