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Substance Use & Misuse May 2013This study aimed to identify the prevalence and determinants of soft tissue infections and self-treatment among injection drug users (IDUs) in California. The study...
This study aimed to identify the prevalence and determinants of soft tissue infections and self-treatment among injection drug users (IDUs) in California. The study interviewed 864 IDUs in California using computer-assisted personal interview (CAPI) from 2003 to 2005. Multiple logistic regression analyses were performed to examine adjusted associations for recent abscess and abscess self-treatment. In these analyses, Latinos had higher odds than African Americans to self-treat, while IDUs reporting a usual place of health care had lower odds of self-treatment. Findings suggest an expansion of wound care facilities to mitigate the self-treatment of abscesses, with special consideration to Latinos.
Topics: Abscess; Adult; California; Cross-Sectional Studies; Drug Users; Female; Humans; Male; Middle Aged; Needle-Exchange Programs; Prevalence; Risk Factors; Risk-Taking; Self Care; Soft Tissue Infections; Substance Abuse, Intravenous
PubMed: 23581506
DOI: 10.3109/10826084.2013.787094 -
Revista Portuguesa de Pneumologia 2008Lung abscesses are cavitating lesions containing necrotic debris caused by microbial infection. Patients with chronic lung disease, bronchial obstruction secondary to... (Review)
Review
Lung abscesses are cavitating lesions containing necrotic debris caused by microbial infection. Patients with chronic lung disease, bronchial obstruction secondary to cancer, a history of aspiration or risk of aspiration caused by alcoholism, altered mental status, structural or physiologic alterations of the pharynx and esophagus, neuromuscular disorders, anesthesia, are among others at higher risk of developing lung abcess. The main bacteriological characteristics, the diagnosis, therapy and prognosis are considered. The problem of antimicrobial resistance is also referred.
Topics: Humans; Lung Abscess; Pneumonia, Aspiration; Prognosis
PubMed: 18265922
DOI: 10.1016/s0873-2159(15)30223-3 -
Medicine Apr 2023Descending necrotizing mediastinitis (DNM) is a rare but severe mediastinal infection. If not diagnosed and treated promptly, the consequences can be very serious. Here,... (Review)
Review
RATIONALE
Descending necrotizing mediastinitis (DNM) is a rare but severe mediastinal infection. If not diagnosed and treated promptly, the consequences can be very serious. Here, we shared a successful diagnosis and treatment case of DNM that originates from oral to neck and mediastinum caused by Streptococcus constellatus (S constellatus). S constellatus is a clinically uncommon gram-positive coccus and is known for its ability to form abscesses. Timely surgical drainage and the correct use of antibiotics are key to successful treatment.
PATIENT CONCERNS
A 53-year-old male admitted to hospital with painful swelling of the right cheek, persistent oral pus and moderate fever lasting 1 week, followed by rapid development of a mediastinal abscess.
DIAGNOSES
He was diagnosed with DNM caused by S constellatus.
INTERVENTIONS
On the evening of admission, an emergency tracheotomy and thoracoscopic exploration and drainage of the right mediastinum, floor of the mouth, parapharynx and neck abscess were performed. Antibiotics were administered immediately.
OUTCOMES
At 28 days post-operatively, the abscess was absorbed, bilateral lung exudate decreased and the patient temperature, aspartate transaminase, alanine transaminase, bilirubin and platelets returned to normal. The patient was discharged after completing 4 weeks of antibiotic therapy. Follow-up at 3 months after discharge revealed no recurrence of the abscess.
LESSONS
Early surgical drainage and antibiotics treatment are important in mediastinal abscesses and infectious shock due to Streptococcus asteroids.
Topics: Male; Humans; Middle Aged; Mediastinitis; Abscess; Streptococcus constellatus; Mediastinum; Mediastinal Diseases; Drainage; Anti-Bacterial Agents; Necrosis
PubMed: 37026905
DOI: 10.1097/MD.0000000000033458 -
BMJ Case Reports Jan 2015Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and...
Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur revealed widespread gas between muscular planes. A retroperitoneal abscess involving the left renal fossa, psoas, iliacus and upper thigh muscles was revealed on an urgent CT scan. The patient was transferred to intensive care unit (ICU) and underwent an emergency drainage. Despite ICU the patient died 2 days after admission.
Topics: Abscess; Aged, 80 and over; Delayed Diagnosis; Diagnosis, Differential; Drainage; Fatal Outcome; Female; Humans; Pain; Retroperitoneal Space; Thigh
PubMed: 25576509
DOI: 10.1136/bcr-2014-207437 -
Medicine Dec 2021A hepatobronchial fistula and lung abscess following a pyogenic liver abscess is a rare entity and it is not easy to diagnose this condition based on the symptoms and...
RATIONALE
A hepatobronchial fistula and lung abscess following a pyogenic liver abscess is a rare entity and it is not easy to diagnose this condition based on the symptoms and chest radiography.
PATIENT CONCERNS
An 81-year-old man presented with productive cough and dyspnea.
DIAGNOSIS
Chest radiography indicated increased opacities in the right lower lung field with an air-fluid level suggestive of pneumonia complicated by a lung abscess. Chest and abdominal computed tomography revealed an abscess in the right lower lung field that bordered an abscess at segment 7 of the liver. Tubography confirmed a fistula between the liver and lung abscesses.
INTERVENTIONS
Due to communication between 2 abscesses, transhepatic approach was done instead of transpleural approach to avoid complications.
OUTCOMES
A liver abscess complicated by a lung abscess was resolved following percutaneous transhepatic drainage of the liver abscess and antibiotic administration.
LESSONS
Though uncommon, the lack of suspicion of sub-diaphragmatic liver abscess often lead to a delay in diagnosis and proper treatment. Our case implies the importance of computed tomography in early diagnosis of liver abscess in case of lung abscess in the right lower lung field.
Topics: Aged, 80 and over; Drainage; Fistula; Humans; Liver; Liver Abscess, Pyogenic; Lung Abscess; Male; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 35049176
DOI: 10.1097/MD.0000000000027789 -
Srpski Arhiv Za Celokupno Lekarstvo 2005Splenic abscess is a rare disease but with increasing frequency. The authors present 9 patients with splenic abscess treated at the Institute of Digestive System...
Splenic abscess is a rare disease but with increasing frequency. The authors present 9 patients with splenic abscess treated at the Institute of Digestive System Diseases, Clinical Centre of Serbia, in a period from January 1, 1986 to May 15, 2004. Splenic abscess was the complication of septic endocarditis in 4, trauma in 2, dental infection in 1, while in 2 cases it was the complication of chemotherapy in myeloproliferative disorders. All 9 patients had fever, 7 - abdominal pain, 4 - left shoulder pain, and 1 patient had nausea and vomiting. Higher white blood count was found in 6 patients, pleural effusion in 4, elevated left hemidiaphragm in 1 and basal pneumonia in 1 patient as well. Ultrasonography and CT were the most reliable diagnostic procedures. CT was superior in diagnosis of multiple small abscesses. Culture of the pus recovered the Enterococcus in 3 cases, Streptococcus a hemolyticus in 1, Staphylococcus epidermidis and Candida albicans in 1, Staphylococcus aureus, E. Coil and Candida albicans in 1, Staphylococcus aureus i Salmonella enteritidis in 1 case. Eight patients underwent splenectomy and 1 was cured by combined antibiotics in high doses. One patient died postoperatively due to septic endocarditis that had been present before surgery. The authors believe that splenectomy and antibiotics administered according to drug susceptibility test as well as management of underlying disease are the method of choice for splenic abscess treatment. Conservative antibiotic treatment is indicated in selected cases only.
Topics: Abscess; Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Splenic Diseases
PubMed: 16053175
DOI: 10.2298/sarh0502046g -
Archives of Emergency Medicine Dec 1988Thirty-seven years ago, it was suggested that abscesses could be treated with primary closure rather than by conventional incision and drainage, and that subsequent... (Review)
Review
Thirty-seven years ago, it was suggested that abscesses could be treated with primary closure rather than by conventional incision and drainage, and that subsequent healing was superior. The result of a survey into the practice and teaching of abscess management in accident and emergency departments shows that, despite apparent satisfaction with the technique, it has not gained widespread acceptance. The literature on the subject is reviewed, and from this review it would appear that there cannot be any justification for the traditional method of packing abscess cavities. Areas for further research are identified.
Topics: Abscess; Drainage; Humans; Surveys and Questionnaires; Wound Healing
PubMed: 3069102
DOI: 10.1136/emj.5.4.200 -
Journal of Animal Science Apr 2016Liver abscesses are the primary liver abnormality of feedlot cattle at slaughter. The incidence of liver abscesses is highly variable, but generally ranges from 10% to... (Review)
Review
Liver abscesses are the primary liver abnormality of feedlot cattle at slaughter. The incidence of liver abscesses is highly variable, but generally ranges from 10% to 20%. The incidence of total and the proportion of severely abscessed livers (A+) are greater in Holsteins fed for beef production and culled dairy cows than in beef breeds. The reason for the greater incidence of liver abscesses in Holstein steers is not known, but one of the reasons is likely because of increased days on feed. The high prevalence in cull cows is likely because no specific intervention, such as use of tylosin in the feed, is approved for use in dairy cows. Liver abscesses are generally a sequela to ruminal acidosis and rumenitis in cattle fed diets high in readily-fermentable carbohydrates and low in roughages; thus, the term "acidosis-rumenitis-liver abscess complex." Liver abscesses are almost always polymicrobial infections with Gram negative anaerobes constituting the predominant flora. Almost all studies have concluded that , a ruminal bacterium, is the primary causative agent and (formerly ) is the secondary pathogen. A limited number of studies have been done on the bacterial flora of liver abscesses of culled dairy cows and Holstein feedlot steers. A recent study has reported on isolation of from liver abscesses of Holstein cattle. The control of liver abscesses in feedlot cattle has depended on the use of antibiotics, particularly tylosin, in the feed combined with sound nutritional management to minimize occurrence of acidosis and subsequent rumenitis. Although there is no evidence of resistance development in , the future of tylosin use as a feed additive in feedlot cattle is uncertain. Regardless, beginning January 2017, the use of tylosin in feedlot cattle for the prevention of liver abscesses will be under veterinary oversight. Although tylosin is widely used in the feedlot industry, there is considerable interest in evaluating antibiotic alternatives, such as essential oils and vaccines, to control liver abscesses. Because liver abscess is a bacterial infection and the pathogenicity and virulence factors of have been studied widely, there have been considerable interest and efforts to develop an efficacious vaccine. The 2 antigens that have been targeted for vaccine production are leukotoxin and outer membrane proteins of .
Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Bacterial Vaccines; Cattle; Cattle Diseases; Liver Abscess
PubMed: 27136021
DOI: 10.2527/jas.2015-0261 -
Medicine Oct 2023Mesenteric abscess, a rare abdominal infection, is regularly mostly secondary to inflammatory bowel disease, diverticula of the small intestine, or tuberculosis. Primary...
RATIONALE
Mesenteric abscess, a rare abdominal infection, is regularly mostly secondary to inflammatory bowel disease, diverticula of the small intestine, or tuberculosis. Primary mesenteric abscesses are extremely rare. If not diagnosed and treated in a timely manner, it may lead to serious consequences; computerized tomography is highly beneficial for the diagnosis of this disease; timely surgical intervention, judicious use of antibiotics, and adequate nutritional support are crucial in the management of this disease.
PATIENT CONCERNS
A 59-year-old male patient from China was admitted to hospital for intermittent abdominal pain accompanied by poor appetite for 10 days. One week before admission, the patient had been infected with corona virus disease 2019. Past history includes type 2 diabetes and post-operative gastric cancer.
DIAGNOSIS
The emergency abdominal computerized tomography examination results of the patient suggested that the mesentery was cloudy with a large amount of effusion and visible bubble. Mesentery abscess was considered, but duodenal perforation could not be excluded.
INTERVENTIONS
We adopted exploratory laparotomy to further clarify the diagnosis. Intraoperatically, after fully exposing the duodenum, we found extensive abscess formation in the mesentery, but no duodenal perforation. After operation, the patient developed duodenal leakage and was treated with gastric tube and jejunal nutrition tube.
OUTCOMES
Postoperatively, due to poor general condition, the patient was transferred to intensive care unit; after anti-infective treatment, the condition improved on the 5th postoperative day, and duodenal leakage appeared on the 9th postoperative day, and conservative treatment was ineffective, and the patient eventually died.
LESSONS
Primary mesenteric abscess is a local tissue infectious disease. Whereas we should consider the physical basic condition of the patient during therapeutic process. We believe adequate postoperative drainage, rational use of antibiotics based on bacterial culture, early ambulation after surgery, and adequate nutritional support might be key points for successful therapy.
Topics: Male; Humans; Middle Aged; Abscess; Klebsiella pneumoniae; Diabetes Mellitus, Type 2; Abdominal Abscess; Peritonitis; Anti-Bacterial Agents
PubMed: 37904375
DOI: 10.1097/MD.0000000000035774 -
Journal of Infection in Developing... May 2020This study aims at defining through a retrospective evaluation, the clinical parameters affecting the clinical course and consequently the management of patients...
INTRODUCTION
This study aims at defining through a retrospective evaluation, the clinical parameters affecting the clinical course and consequently the management of patients presenting with cervicofacial abscesses.
METHODOLOGY
A total of 394 patients diagnosed with abscess at the University of Sassari Otorhinolaryngology Division between 2009 and 2017 were included; among these, eleven patients were diagnosed with necrotizing fasciitis. Personal and clinical parameters including the LRINEC score and the medical and/or surgical treatment used were analyzed for each patient. The most frequently affected site was the peritonsillar space (76.9%), followed by the parapharyngeal space.
RESULTS
Mean age was 41(±17) years, the male population was slightly overrepresented (68%). An average of 6 (±7) days of hospitalization duration was recorded. The mortality rate was confirmed to be relatively low (1/349 patients) and was reported only in one patient diagnosed with necrotizing fasciitis (1/11).
CONCLUSION
Diagnosis, correct clinical definition and early medical-surgical treatment of neck abscesses were crucial to reduce complications; LRNEC score, C-reactive protein, glycemia and creatininemia proved to be reliable prognostic indicators of difficult patient management and risk of complications.
Topics: Abscess; Adult; Disease Management; Face; Fasciitis, Necrotizing; Female; Hospitalization; Humans; Male; Middle Aged; Neck; Retrospective Studies; Risk Factors; Young Adult
PubMed: 32525840
DOI: 10.3855/jidc.12191