1/46. Localised upper airway obstruction in a patient with acquired immunodeficiency syndrome.We describe a case of rapidly progressive upper airway obstruction due to tracheal Pseudomonas abscesses in a patient with acquired immunodeficiency syndrome. The case highlights the aggressive nature of pseudomonas infections and the difficulty of eradicating this organism in patients infected with the human immunodeficiency virus.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/46. aspergillus mycetoma in a secondary hydroxyapatite orbital implant: a case report and literature review.OBJECTIVE: The authors describe the first case report of a fungal abscess within a hydroxyapatite orbital implant in a patient who had undergone straightforward secondary hydroxyapatite implant surgery. DESIGN: Case report and literature review. INTERVENTION: Four months postoperatively after pegging and 17 months after original implant placement, chronic discharge and socket irritation became evident. Recurrent pyogenic granulomas were a problem, but no obvious area of dehiscence was present over the implant. The peg and sleeve were removed 31 months after pegging (44 months after original placement of the implant). The pain and discharge did not resolve, and the entire hydroxyapatite orbital implant was removed 45 months after sleeve placement and 58 months after initial implant placement. The pain and discharge settled rapidly. MAIN OUTCOME MEASURES: Cultures and histopathology. RESULTS: Results of bacterial cultures were negative. Results of histopathologic examination of the implant disclosed intertrabecular spaces with multiple clusters of organisms consistent with aspergillus. CONCLUSIONS: Persistent orbital discomfort, discharge, and pyogenic granulomas after hydroxyapatite implantation should cause concern regarding potential implant infection. The authors have now shown that this implant infection could be bacterial or fungal in nature. This is essentially a new form of orbital aspergillus, that of a chronic infection limited to a hydroxyapatite implant.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/46. Mediastinal histoplasmosis with abscess.A mediastinal mass of clinically undetermined nature was found at autopsy to be an enormous abcess due to secondary infection in granulamatous caseating mediastinal nodes caused by Hitosplasma capsulatum. Other complications of mediastinal histoplasmosis are briefly reviewed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/46. Typhoidal focal suppurative lymphatic abscess.We describe a submandibular suppurative lymphatic abscess caused by salmonella typhi in an 8-year-old child. The diagnosis was confirmed by repeated isolation of S. typhi from the abscess. A literature search found no previous report of a similar nature and this therefore seems to be the first case report of focal suppurative typhoidal lymphatic abscess. The child responded to cephalexin and surgical drainage.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/46. pseudomonas aeruginosa liver abscesses after diagnostic endoscopic retrograde cholangiography in two patients with sphincter of oddi dysfunction type 2.patients with sphincter of oddi dysfunction have a significantly increased rate of pancreatitis after manometry or sphincterotomy, but septic complications after diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in patients with sphincter of oddi dysfunction type 2 have not been reported. We describe two patients with sphincter of oddi dysfunction type 2 in whom pseudomonas aeruginosa serotype 10 septicemia and multiple small hepatic abscesses developed, all within 48 h after they underwent diagnostic ERCP. The sepsis and hepatic abscesses resolved after successful intravenous antibiotic administration. Despite scrupulous examination of the duodenoscope washing machine and the bottle of water, the bacteria responsible for the sepsis could not be isolated. It is possible that despite disinfection, a nondetectable colony of P. aeruginosa remained in a part of duodenoscope and proliferated to reach a potentially hazardous level the following day. This report highlights the importance administering antibiotic prophylaxis to patients with sphincter Oddi dysfunction type 2 who undergo ERCP, despite the functional nature of the disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/46. Perianal mucinous adenocarcinoma: unusual case presentations and review of the literature.Perianal mucinous adenocarcinoma is a rare cancer constituting 3 to 11 per cent of all anal carcinomas. It may arise de novo or from a fistula or abscess cavity. We present two cases of this disease process. Case One is a 52-year-old man with a chronic history of perianal abscesses who presented to the emergency room with a large bowel obstruction. He required diversion and wide local excision with lateral internal sphincterotomy for relief of the obstruction. pathology from the excised material revealed the unexpected diagnosis of invasive mucinous adenocarcinoma of the anus. Case Two is a 59-year-old man with a chronic history of complex fistulas and abscesses who presented to our office with a horseshoe fistula and deep postanal space abscess. Because of the nonhealing nature of the wound, biopsies from the abscess crater, fistulous tract, and the perianal skin opening were taken. The pathology department identified the specimens as invasive mucinous adenocarcinoma of the anal canal. This is an aggressive cancer often misdiagnosed clinically as benign pathology. A high index of suspicion and biopsy of fistulous tracts and abscesses are the keys to early diagnosis and treatment. With combination chemotherapy and radiation therapy in conjunction with aggressive surgical resection long-term survival might be obtained.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/46. ludwig's angina: an uncommon cause of chest pain.A 71-year-old male with coronary artery disease, hypertension, diabetes mellitus, tobacco and opioid dependence came to the emergency room complaining of one episode of retrosternal chest pain oppressive in nature of one day of evolution. He had acute respiratory distress and required mechanical ventilation. The initial impression was myocardial ischemia, but electrocardiography and cardiac enzymes ruled it out. During the following hours, neck and tongue edema developed. He was started on broad-spectrum antibiotics empirically. neck computed tomography scan revealed a left parapharyngeal and submandibular abscess. The abscess was drained. The source of infection was found on the second molar of the left lower jaw. The patient improved and was successfully weaned from mechanical ventilation. Despite advances in therapy, ludwig's angina remains a potentially lethal infection in which early recognition plays a crucial role.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/46. Postoperative herniation of the caecum through the gastroepiploic foramen.Herniation through the gastroepiploic foramen into the lesser sac is a rare cause of intestinal obstruction. The nonspecific nature of its presentation makes early diagnosis of this condition difficult. Internal herniation should be considered with a high index of suspicion in intestinal obstruction due to the high rate of morbidity and mortality associated with delayed treatment. We report the first case of caecal herniation with strangulation in the gastroepiploic foramen occurring in a postoperative patient. decompression and reduction of the strangulated caecum was performed, followed by a right hemicolectomy. The clinical and radiological features are presented from a review of the literature on gastroepiploic foramen herniation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/46. Isolation of enterococcus faecalis from a case of nonpuerperal breast abscess.Nonpuerperal breast abscess (NPBA) has different etiology as compared to the mastitis occurring in post partum women. The condition presents either as acute suppurative infection or chronic type. Organisms usually implicated are staphylococcus aureus, coagulase negative staphylococci, and anaerobes. Mostly the infection is polymicrobial in nature. Herein, we report the isolation of enterococcus faecalis from a case of acute suppurative NPBA.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/46. abscess of the iliopsoas muscle diagnosed by magnetic resonance imaging and ultrasonography.We have reported a case of abscess of the iliopsoas muscle, in which a limp and hip pain pointed toward pathology of the hip. The diagnosis in such cases may be difficult unless there is close attention to the clinical history and a good physical examination is obtained. One ultrasonographic examination of the hip in such a patient, subtle differences between the iliopsoas muscles should alert the radiologist to examine the psoas muscle. ultrasonography is instrumental in demonstrating the solid or cystic nature of the iliopsoas mass, while MRI depicts the extent and proximity of adjacent organs. Once an iliopsoas abscess is diagnosed, treatment includes parenteral antibiotics and drainage.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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