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Postgraduate Medical Journal Aug 2004Iliopsoas abscess is a relatively uncommon condition that can present with vague clinical features. Its insidious onset and occult characteristics can cause diagnostic... (Review)
Review
Iliopsoas abscess is a relatively uncommon condition that can present with vague clinical features. Its insidious onset and occult characteristics can cause diagnostic delays, resulting in high mortality and morbidity. The epidemiology, aetiology, clinical features, and management of iliopsoas abscess are discussed.
Topics: Adult; Anti-Bacterial Agents; Drainage; Early Diagnosis; Humans; Male; Physical Examination; Psoas Abscess; Psoas Muscles
PubMed: 15299155
DOI: 10.1136/pgmj.2003.017665 -
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 -
Acta Gastro-enterologica Belgica 2022Liver abscesses are rare in the Western pediatric population and data on predisposing factors and etiology are scarce. We aimed to describe predisposing factors,...
BACKGROUND AND STUDY AIMS
Liver abscesses are rare in the Western pediatric population and data on predisposing factors and etiology are scarce. We aimed to describe predisposing factors, microbiological characteristics, and treatment.
PATIENTS AND METHODS
Retrospective analysis of children admitted to two tertiary care hospitals in Belgium from 1 January 1996 to 31 December 2019. We analyzed clinical features, predisposing factors, imaging characteristics, microbiological data, treatment, and outcome in children with a liver abscess and compared these data with the literature.
RESULTS
We collected 24 cases with a male to female ratio of 1.4 and a median age of 3.2 years at time of diagnosis. Survival was 95.8%. Invasive culture specimens were obtained in 83.3% and showed growth of bacteria in 55%. Parenteral antibiotics were administered before invasive culture sampling in 80%. Liver abscesses were cryptogenic in four (16.7%) patients. Hepatobiliary disease was the most prevalent predisposing factor (n = 6; 25%), followed by recent antineoplastic therapy for malignancies (n = 5; 20.8%), intra-abdominal surgical pathology (n = 4; 16.7%) and umbilical venous catheters (n = 2; 8.3%). In two patients there was a parasitic origin (n = 2; 8.3%) and in one it was caused by Bartonellosis. There was no diagnosis of chronic granulomatous disease (CGD) in our cohort.
CONCLUSIONS
Pediatric liver abscesses have a favorable outcome in the developed world. Whenever feasible, invasive abscess culture specimens should be obtained. In patients presenting with a cryptogenic liver abscess or atypical disease course, immunological workup should be ensured.
Topics: Anti-Bacterial Agents; Belgium; Child; Child, Preschool; Female; Hospitalization; Humans; Liver Abscess; Male; Retrospective Studies
PubMed: 35833905
DOI: 10.51821/85.3.10211 -
Journal of Ultrasound Dec 2022To explore the value of an ultrasound contrast agent (Sonovue) as an interventional treatment for periappendiceal abscesses.
OBJECTIVES
To explore the value of an ultrasound contrast agent (Sonovue) as an interventional treatment for periappendiceal abscesses.
METHODS
From January 2019 to December 2020, 30 patients were recruited who were admitted to Jinan Central Hospital due to periappendiceal abscesses. Before the operation, 2.5 ml of SonoVue contrast agent was injected intravenously to determine the non-enhanced area of liquefaction and necrosis in the abscess cavity. The puncture sites were selected. Percutaneous catheterization and drainage (PCD) were performed under contrast-enhanced ultrasound guidance. After the operation, 1 ml of diluted SonoVue suspension was injected through the drainage tube to observe the position of the drainage tube, the degree of drainage and the development of the abscess.
RESULTS
An ultrasound contrast agent was used preoperatively to assess the extent of the abscess. Liquefaction and necrosis were observed in the abscess cavity. CEUS showed hyperenhancement in the wall of the abscess in the arterial phase and the liquefied necrotic area in the abscess cavity was not enhanced before PCD. CEUS allowed operators to confidently identify the puncture site. Amongst the 30 cases of PCD, 27 cases showed the clear positioning of the drainage tube. The head of the drainage tube was placed in the ideal position and development could be seen in the abscess cavity. The diffusion effect of the contrast agent was good with no spillover and the drainage was unobstructed. Abscess development was observed in 3 patients after puncture injection of the contrast agent but the head of the drainage tube was not in the predetermined position. After adjusting the position of the drainage tube, CEUS was repeated and showed a strong diffusion effect of the contrast agent.
CONCLUSIONS
Intravenous injection of Sonovue before PCD of periappendiceal abscesses can evaluate the extent of the abscess, liquefaction and necrosis in the abscess cavity. The approach can also provide guidance for the placement of the drainage tube. After the operation, a diluted contrast agent was injected through the drainage tube. The position of the drainage tube and the flow direction of the contrast agent could be seen. This approach has good value for clinical applications to accurately judge the position of the drainage tube.
Topics: Humans; Abscess; Contrast Media; Sulfur Hexafluoride; Necrosis
PubMed: 35842917
DOI: 10.1007/s40477-022-00692-1 -
British Medical Journal Dec 1977
Topics: Abscess; Anti-Bacterial Agents; Drainage; Humans; Skin Diseases, Infectious
PubMed: 589300
DOI: No ID Found -
American Family Physician Jul 2003Bartholin's duct cysts and gland abscesses are common problems in women of reproductive age. Bartholin's glands are located bilaterally at the posterior introitus and... (Review)
Review
Bartholin's duct cysts and gland abscesses are common problems in women of reproductive age. Bartholin's glands are located bilaterally at the posterior introitus and drain through ducts that empty into the vestibule at approximately the 4 o'clock and 8 o'clock positions. These normally pea-sized glands are palpable only if the duct becomes cystic or a gland abscess develops. The differential diagnosis includes cystic and solid lesions of the vulva, such as epidermal inclusion cyst, Skene's duct cyst, hidradenoma papilliferum, and lipoma. The goal of management is to preserve the gland and its function if possible. Office-based procedures include insertion of a Word catheter for a duct cyst or gland abscess, and marsupialization of a cyst; marsupialization should not be used to treat a gland abscess. Broad-spectrum antibiotic therapy is warranted only when cellulitis is present. Excisional biopsy is reserved for use in ruling out adenocarcinoma in menopausal or perimenopausal women with an irregular, nodular Bartholin's gland mass.
Topics: Abscess; Bartholin's Glands; Catheterization; Cysts; Drainage; Female; Humans; Vulvar Diseases
PubMed: 12887119
DOI: No ID Found -
Andes Pediatrica : Revista Chilena de... Apr 2022Kidney abscess is an unusual entity in childhood with few studies about its clinical characteris tics.
UNLABELLED
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.
Topics: Abdominal Abscess; Abscess; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Kidney Diseases; Male; Retrospective Studies; Urinary Tract Infections; Vesico-Ureteral Reflux
PubMed: 35735301
DOI: 10.32641/andespediatr.v93i2.3765 -
American Journal of Men's Health 2022The prostatic abscess is a rare complication of a bacterial infection of the prostate. Since the early use of potent antibiotics to treat urinary tract infections, the... (Review)
Review
The prostatic abscess is a rare complication of a bacterial infection of the prostate. Since the early use of potent antibiotics to treat urinary tract infections, the incidence of the prostatic abscess has declined significantly. In keeping with that, prostatic abscess combined with abscesses in the spleen or other distant organs become an extremely rare but fatal clinical condition. Here, we present a case of prostate and spleen abscess due to multi-drug-resistant gram-negative bacilli without obvious risk factors. The patient initially complained of high-grade fever and dysuria. After screening the source of infection by computed tomography (CT) scans, prostate and spleen abscesses were diagnosed. In addition, extended-spectrum beta-lactamase positive was detected both in urine and blood culture. The patient was successfully treated by a transurethral resection of the prostate followed by splenic puncture and drainage, as well as intravenous administration of meropenem. Although the prostate abscess combined with spleen abscess was rare, the possibility of dissemination in remote tissues should be taken into consideration before the surgical treatment of prostatic abscesses. The concurrent drainage of multiple abscesses followed by intensive and sensitive antibiotics was safe and effective for indicated patients.
Topics: Abscess; Anti-Bacterial Agents; Humans; Male; Prostatic Diseases; Spleen; Transurethral Resection of Prostate
PubMed: 35801533
DOI: 10.1177/15579883221108898 -
Laeknabladid Jan 2013Brain abscess is a life threatening illness, demanding rapid diagnosis and treatment. Its development requires seeding of an organism into the brain parenchyma, often in... (Review)
Review
Brain abscess is a life threatening illness, demanding rapid diagnosis and treatment. Its development requires seeding of an organism into the brain parenchyma, often in an area of damaged brain tissue or in a region with poor microcirculation. The lesion evolves from a cerebritis stage to capsule formation. Brain abscesses can be caused by contiguous or haematogenous spread of an infection, or by head trauma/ neurosurgical procedure. The most common presentation is that of headache and vomiting due to raised intracranial pressure. Seizures have been reported in up to 50% of cases. Focal neurological deficits may be present, depending on the location of the lesion. Treatment of a brain abscess involves aspiration or excision, along with parenteral antibiotic therapy. The outcome has improved dramatically in the last decades due to improvement in diagnostic techniques, neurosurgery, and broad-spectrum antibiotics. The authors provide an overview of the pathogenesis, diagnosis and management of brain abscesses.
Topics: Anti-Bacterial Agents; Brain Abscess; Humans; Magnetic Resonance Imaging; Neurosurgical Procedures; Predictive Value of Tests; Risk Factors; Treatment Outcome
PubMed: 23341403
DOI: 10.17992/lbl.2013.01.478 -
Medicina (Kaunas, Lithuania) Feb 2021Renal and perirenal abscesses are very rare in children. They can be present as an acute emergency condition or insidiously as a chronic disease. The diagnosis is not so... (Review)
Review
Renal and perirenal abscesses are very rare in children. They can be present as an acute emergency condition or insidiously as a chronic disease. The diagnosis is not so obvious, and it is a big challenge, especially when it can simulate a kidney tumor. The treatment can be conservative, preferably with targeted antibiotics, or surgical, consisting primarily of drainage. This publication aims to present a clinical case in which both diagnosis and treatment were a big challenge for the entire treatment team. A 10-year-old male patient was admitted to the hospital because of mild abdominal pain and a temperature of 37.5 °C. The symptoms lasted for a week. In the computed tomography (CT), the lesion's dimensions were 11.1 × 8.2 × 25 cm, and inflammation, abscess, cyst, and abdominal tumor have been suggested. The decision about surgical treatment was made. An enormous abscess near the right kidney was localized. The patient's condition stabilized after surgery. Unfortunately, due to persistent purulent reservoirs, a second laparotomy was necessary. During the extensive diagnostic cystourethrography performed, vesicoureteral reflux was visualized. In conclusion, though a perinephric abscess is very rare in children, it should be taken into consideration in patients with non-specific abdominal symptoms. The imaging using ultrasound and CT scan with contrast enhancement is crucial to recognize and properly treat the condition. In terms of a small abscess, the only antimicrobial treatment using antibiotics of a broad spectrum can be considered. However, the drainage of an abscess, either percutaneous or open, should be used. For the large abscess, the open drainage seems to be a primary method of treatment. The importance of cooperation in a multidisciplinary team is crucial, as the diagnosis and treatment of underlying causes are essential.
Topics: Abscess; Child; Drainage; Humans; Kidney Diseases; Male; Retrospective Studies; Ultrasonography
PubMed: 33572093
DOI: 10.3390/medicina57020154