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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 -
HPB Surgery : a World Journal of... Jul 1990Twelve patients (9 men, 3 women) with a mean age of 65 (54-78) years, with pyogenic hepatic abscesses were managed by percutaneous drainage between 1979 and 1987.... (Review)
Review
Twelve patients (9 men, 3 women) with a mean age of 65 (54-78) years, with pyogenic hepatic abscesses were managed by percutaneous drainage between 1979 and 1987. Biliary origin was most common (4 patients), followed by hepatic abscesses as a late postoperative complication (seen in 3 patients) and hepatic abscesses occurring in association with acute appendicitis (2 patients). The origin was unknown in 3 patients. Diagnosis was reached by computed tomography or ultrasonography with a diagnostic delay of in mean 11 days. Seventeen abscesses were found among the 12 patients. The median abscess size (maximal diameter) was 7 (1-12) cm. Nine patients were treated with percutaneous drainage with an indwelling catheter within the abscess cavity for up to 3 weeks, while 3 patients were managed with percutaneous puncture and aspiration alone. The most commonly isolated organism from the drained hepatic abscess was E. coli. The course following percutaneous treatment was uneventful, without mortality and recurrence of the hepatic abscess during follow-up. One patient required surgical drainage of an additional hepatic abscess. Percutaneous drainage of hepatic abscesses, independent of origin, thus seems as a safe and reliable method, which should be considered as the treatment of choice if facilities and knowledge of percutaneous management are provided.
Topics: Aged; Drainage; Female; Humans; Liver Abscess; Male; Middle Aged; Radiography; Suppuration; Ultrasonography
PubMed: 2278915
DOI: 10.1155/1990/28345 -
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 -
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 -
Medicine Jul 2019Tuberculous retropharyngeal abscess is rare, but it can be fatal if not treated appropriately. It usually occurs secondary to tuberculosis of the cervical spine....
RATIONALE
Tuberculous retropharyngeal abscess is rare, but it can be fatal if not treated appropriately. It usually occurs secondary to tuberculosis of the cervical spine. Moreover, tuberculous abscess involving the chest wall is relatively rare in skeletal tuberculosis. Although the optimal treatment is controversial, most clinicians suggest a combination of sufficient antituberculous medication and complete resection to prevent recurrence and increase therapeutic efficacy. Herein, we present an unusual case of retropharyngeal abscess with cervical Pott disease and tuberculous abscess of the chest wall.
PATIENT CONCERNS
The patient was a 27-year-old Indonesian woman who had neck pain, dysphagia, and odynophagia, but no neurological deficit. Examination of the oral cavity showed anterior displacement of the posterior pharyngeal wall. The mass over the right anterior chest wall measured approximately 5 × 4 cm in size.
DIAGNOSES
Radiography and computed tomography findings were suggestive of retropharyngeal abscess extending to the cervical spine and chest wall abscess.
INTERVENTIONS
She was admitted to the hospital for treatment. Drainage of the retropharyngeal and chest wall abscesses with debridement of the chest wall was performed.
OUTCOMES
No complications occurred after early surgical treatment and administration of antituberculous medication. The patient recovered well and went back to her own country after discharge.
LESSONS
Tuberculous retropharyngeal abscess with Pott disease and tuberculous abscess of the chest wall are both complicated diagnoses that physicians have to consider in similar patient presentations.
Topics: Abscess; Adult; Antitubercular Agents; Drainage; Female; Humans; Mycobacterium tuberculosis; Retropharyngeal Abscess; Thoracic Wall; Tomography, X-Ray Computed; Tuberculosis, Spinal
PubMed: 31277156
DOI: 10.1097/MD.0000000000016280 -
The Western Journal of Medicine Feb 1982Perinephric and intranephric (renal cortical and corticomedullary) abscesses, which may coexist, are associated with considerable mortality (21 percent to 56 percent)... (Review)
Review
Perinephric and intranephric (renal cortical and corticomedullary) abscesses, which may coexist, are associated with considerable mortality (21 percent to 56 percent) and are often difficult to diagnose. Most cases of renal cortical abscess are due to hematogenous seeding from distant foci of infection (often involving Staphylococcus aureus), while corticomedullary and perinephric abscesses are most often due to complications of urinary tract infections. Newer noninvasive studies such as ultrasonography, computerized tomography, gallium scanning and indium-labeled leukocyte scanning may facilitate determination of the diagnosis. While antibiotic therapy alone may suffice for the treatment of cortical abscesses, surgical drainage is an added requirement for the treatment of perinephric abscess.
Topics: Abscess; Bacterial Infections; Diagnosis, Differential; Humans; Kidney Diseases; Radiography; Radionuclide Imaging
PubMed: 7039139
DOI: No ID Found -
The American Journal of Case Reports Jul 2022BACKGROUND 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...
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.
Topics: Abdominal Abscess; Abscess; Aged, 80 and over; Clostridioides; Clostridioides difficile; Humans; Male; Necrosis; Splenic Diseases
PubMed: 35906763
DOI: 10.12659/AJCR.936528 -
Internal Medicine (Tokyo, Japan) Mar 2022A 50-year-old man developed a sterile cavernosal abscess followed by prominent features of necrotizing neutrophilic dermatosis. We conducted a literature review, which... (Review)
Review
A 50-year-old man developed a sterile cavernosal abscess followed by prominent features of necrotizing neutrophilic dermatosis. We conducted a literature review, which revealed that aseptic abscesses in the corpus cavernosum occur in association with neutrophilic dermatosis. Patients with this condition frequently receive unnecessary antibiotic treatment and surgical interventions. Although this condition responds to systemic corticosteroids, the functional prognosis of the penis is poor. Abscess formation may be the initial presentation of neutrophilic dermatoses, and underlying conditions may even be absent. Clinicians need to be aware of this condition to distinguish it from bacterial infection and initiate early disease-specific treatments.
Topics: Abscess; Humans; Male; Middle Aged; Pyoderma Gangrenosum; Skin Diseases
PubMed: 34483210
DOI: 10.2169/internalmedicine.7994-21 -
Fertility and Sterility Aug 2013To report a case of pelvic actinomycosis presenting as large, multiloculated abscesses after an in vitro fertilization (IVF) cycle for male factor infertility. (Review)
Review
OBJECTIVE
To report a case of pelvic actinomycosis presenting as large, multiloculated abscesses after an in vitro fertilization (IVF) cycle for male factor infertility.
DESIGN
A case report and literature review.
SETTING
University hospital.
PATIENT(S)
A 31-year-old nulligravid woman presenting with urinary retention, pelvic pain, and fever 6 days after transvaginal oocyte retrieval and an embryo transfer for male factor infertility.
INTERVENTION(S)
Intravenous and oral antimicrobial therapy, and computed tomography (CT)-guided drainage of pelvic abscesses.
MAIN OUTCOME MEASURE(S)
Clinical and radiologic resolution of symptoms and infection.
RESULT(S)
The CT scan revealed several large, multiloculated pelvic and tuboovarian abscesses. The patient defervesced after 6 days of intravenous antibiotics, but the pelvic pain did not improve. After CT-guided drainage of the pelvic abscesses, the patient's symptoms improved. The drained material was cultured, and the patient was diagnosed with pelvic actinomycosis tuboovarian abscesses, an infrequent cause of tuboovarian abscess and a rare complication of assisted reproductive technology (ART). The patient was switched from intravenous to oral antibiotics and discharged home.
CONCLUSION(S)
Pelvic Actinomyces israelii presenting as pelvic abscesses may occur as a rare complication of ART. Physicians should consider a diagnosis of tuboovarian abscess in a patient reporting fever and pelvic pain after IVF and embryo transfer.
Topics: Abscess; Actinomycosis; Adult; Embryo Transfer; Female; Fertilization in Vitro; Fever; Humans; Male; Pelvic Pain; Pelvis; Pregnancy; Pregnancy Complications, Infectious
PubMed: 23684115
DOI: 10.1016/j.fertnstert.2013.04.018 -
Journal of Stomatology, Oral and... Nov 2022Odontogenic infections can spread through different routes to more remote anatomical areas, such as the brain. Brain abscesses have an incidence of 0.3-1.3 / 100,000...
PURPOSE
Odontogenic infections can spread through different routes to more remote anatomical areas, such as the brain. Brain abscesses have an incidence of 0.3-1.3 / 100,000 population and only 2-5% are of dental origin. The main objective is to research brain complications derived from odontogenic infections. Secondary objectives were to identify the most common symptoms in brain abscess, to describe the microbiology involved in these infectious processes, report which parts of the brain complex are most commonly affected and report the sequelae of this patients.
METHODS
A systematic review following the PRISMA Guide and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was carried out in PubMed, Scopus and Web of Science. The search terms were: Brain infection, brain abscess, oral health oral origin, odont* infect*.
RESULTS
The database search identified a total of 1000 articles. A total of 18 publications were identified after applying inclusion and exclusion criteria. A total of 38 patients were analyzed. Mean age was 49.64±18.80 years.
CONCLUSION
The most common symptoms of patients with brain abscess are neurological affectations first and then fever and headache second, without necessarily presenting as a symptomatological triad. Microbiological diagnosis is key to determining the origin of the infection. Anaerobic pathogens such as Streptococcus (F. Milleri), Fusobacterium Nucleatum and Porfiromonas Gingivalis families are common bacterial agents. The frontal lobe is the most frequently affected, followed by the parietal and temporal lobe. The most frequent brain complications are neurological disorders. However, most patients with brain abscesses recover without sequelae.
Topics: Humans; Adult; Middle Aged; Aged; Brain Abscess; Incidence; Brain
PubMed: 35908649
DOI: 10.1016/j.jormas.2022.07.018