1/16. Infratentorial subdural empyema, pituitary abscess, and septic cavernous sinus thrombophlebitis secondary to paranasal sinusitis: case report.OBJECTIVE AND IMPORTANCE: Infratentorial empyema, pituitary abscess, and septic cavernous sinus thrombophlebitis are all rare and potentially lethal conditions. The occurrence of all three in a single patient has not previously been described. We present such a case occurring in a young, otherwise healthy man. CLINICAL PRESENTATION: A 26-year-old man with a remote history of sinusitis developed rapidly progressive headache, fever, right eye pain, swelling, proptosis, and visual impairment. magnetic resonance imaging demonstrated diffuse pansinusitis, including sphenoid sinusitis, and extension of inflammation and infection into the adjacent cavernous sinuses, pituitary gland, and posterior fossa. INTERVENTION: Urgent drainage of the ethmoid and maxillary sinuses was performed; pus was not identified. The patient continued to deteriorate clinically with worsening of visual acuity. Computed tomography of the head performed the next day revealed worsening hydrocephalus and an enlarging posterior fossa subdural empyema. Urgent ventricular drainage and evacuation of the empyema was performed, and subsequently, the patient's clinical course improved. The microbiology results revealed alpha hemolytic streptococcus and coagulase-negative staphylococcus species. The patient survived but during the follow-up period had a blind right eye and pituitary insufficiency. CONCLUSION: Paranasal sinusitis can have devastating intracranial sequelae. Involvement of the adjacent pituitary gland and cavernous sinuses can result in serious neurological morbidity or mortality, and retrograde spread of infection through the basal venous system can result in subdural or parenchymal brain involvement. A high index of suspicion and aggressive medical and surgical treatment are crucial for patient survival, but the morbidity rate remains high. Our patient survived but lost anterior pituitary function and vision in his right eye.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
2/16. Lemierre's syndrome with spondylitis and pulmonary and gluteal abscesses associated with mycoplasma pneumoniae pneumonia.Lemierre's syndrome, a systemic anaerobic infection caused by fusobacterium necrophorum, is characterized by an acute oropharyngeal infection, septic thrombophlebitis of the internal jugular veins, sepsis, and multiple metastatic infections. It commonly leads to pulmonary parenchymal abscesses and occasionally to septic arthritis, osteomyelitis, or liver or spleen abscesses. Reported here is a case of spondylitis and pulmonary and gluteal abscesses that occurred as part of a classic presentation of Lemierre's syndrome. Treatment with imipenem and clindamycin was successful.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
3/16. Medical treatment of a central vein suppurative thrombosis with cerebral metastatic abscesses in a burned child.A 2-year-old girl admitted with third degree burns (35% TBSA) received 7 weeks poly-antibiotic therapy combined with heparin for a severe Methicillin-resistant Staphylococcus aureus sepsis with multiple metastatic abscesses (lung, skin, brain), from a suppurative thrombophlebitis of the right jugularis interna, extended to the axillary and cava superior veins. Surgical treatment was contraindicated by the local extension. The child was discharged without major neurological sequelae 3 months after admission.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
4/16. Anaerobic infections in surgery: clinical review.Anaerobic bacteria are being recognized with increasing frequency as important micro-organisms in surgical infections. clostridium, Bacteriodes, Fusobacterium, and peptostreptococcus are the clinically prominent pathological anaerobes. All are commensals and, consequently, most anaerobic infections are endogenous in origin. In the colon, anaerobes are 1,000 times more prevalent than aerobes. This has important implications regarding the management of gastrointestinal tract operations and the treatment of infections originating from the bowel. Typical anaerobic infections include gas gangrene, brain abscess, oral infections, putrid lung abscesses, intra-abdominal abscesses, and wound infections following gynecologic and bowel surgery, perirectal abscesses, postabortal infections, and septic thrombophlebitis. Infections with anaerobic organisms must be suspected when there is feculent odor and/or gas production following gynecologic or bowel surgery, when there are organisms on gram staining but no growth on aerobic cultures, or when septicemia is associated with repeatedly negative blood cultures. debridement and drainage constitute the main stay of treatment. All anaerobes are sensitive to chloramphenicol and clindamycin and all but bacteroides fragils are sensitive to penicillin. Identification of anaerobes requires proper specimen sampling, immediate culturing on prereduced media, and careful gram staining of clinical material. The frequency of anaerobic organisms in surgical infections generally is not recognized by many surgeons; their importance needs to be stressed in the future.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
5/16. lemierre syndrome variant: necrobacillosis associated with inferior vena cava thrombosis and pulmonary abscesses after trauma-induced leg abscess.fusobacterium necrophorum, a rarely encountered but potentially lethal bacterial pathogen, is the cause of lemierre syndrome, an oropharyngeal infection complicated by jugular vein thrombophlebitis and metastatic septic embolization. We describe an unusual variant of this disease in a man who developed F necrophorum sepsis (associated with extensive inferior vena cava and common femoral vein thrombosis) and multiple abscesses in the lungs after a trauma-associated abscess of the left lower extremity. We highlight the predilection of F necrophorum to cause a potentially fatal septic illness irrespective of its primary focus and emphasize the importance of this bacterium as a cause of considerable morbidity.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
6/16. Concomitant bilateral orbital and brain abscesses--unusual complications of pediatric rhinosinusitis.Rhinosinusitis is a common medical problem. Complications involving the orbits or brain are not frequently met. Concomitant involvement of both orbits and the brain is very rare. We here describe a 6-year-old girl who suffered from acute rhinosinusitis and initially, subperiosteal abscesses in both orbits. Bilateral functional endoscopic sinus surgery and drainage of the subperiosteal abscesses through the upper eyelids were done. Pus cultures showed methicillin-resistant staphylococcus aureus. The brain abscesses were found under magnetic resonance imaging (MRI) and were treated conservatively with vancomycin and rifampin for 7 weeks. The patient was free of ouular and necurologic sequelae at the 1-year follow up. Retrograde thrombophlebitis instead of anatomic dehiscence was the most likely route for the spread of infection. Multidisciplinary approaches are necessary in managing ophthalmologic and intracranial complications of sinusitis.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
7/16. Lemierre's syndrome: the link between a simple sore throat, sore neck and pleuritic chest pain.An unusual case of tonsillitis which showed progression to this rare syndrome despite treatment with intravenous antibiotics. Lemierre's syndrome is a rare condition characterised by a triad of: sepsis, thrombophlebitis of the internal jugular vein along with pleuropulmonary and/or distant metastatic abscesses. diagnosis rests on a high index of suspicion and is confirmed by culture of Fusobacterium spp. from blood or infected sites. Radiological investigations are established aids for confirmation of diagnosis. Treatment is with appropriate antibiotics for at least 6 weeks and surgical drainage of abscesses if required. This case has been presented to highlight the mode of presentation, diagnostic tools employed and the management of the complications that featured in this condition.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
8/16. lemierre syndrome complicating a subcutaneous neck abscess.lemierre syndrome is septic thrombophlebitis of the internal jugular vein caused typically by an oropharyngeal infection. We report a case of lemierre syndrome complicating a subcutaneous neck abscess. lemierre syndrome should be considered in the differential diagnosis of septic emboli and sepsis, especially in a patient with tenderness along the sternomastoid muscle.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
9/16. Septic ischial bursitis in systemic lupus erythematosus presenting as a perirectal mass.We describe a patient with systemic lupus erythematosus with dissection of a large ischial bursal cyst which presented as a perirectal mass. Dissecting bursal and articular synovial cysts are known to cause multiple complications including a number of "pseudosyndromes" such as pseudothrombophlebitis. The cyst in this case was initially thought to represent a perirectal abscess and we propose the term "pseudoperirectal abscess" to describe this condition. This cyst was found to be infected and required an extended course of antibiotics and bursectomy.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
10/16. The association of septic thrombophlebitis with subperiosteal abscesses in children.An association of septic thrombophlebitis with acute osteomyelitis in four children is described. Each patient presented with physical findings consistent with thrombophlebitis. Venography, done in two, demonstrated significant acute thrombophlebitis, and another had an infected venous cutdown. A subperiosteal abscess was the predominant bony involvement found in all three patients who underwent surgical drainage. The initial radiographs were normal in each case. Bone scans showed diffuse increase in activity in the extremity, consistent with hyperemia, but no focal areas of increased uptake to suggest osteomyelitis. Computerized tomography, done in two patients, failed to reveal any bony abnormality, although subperiosteal abscesses were drained within 48 hours of each study. The existence of reverse collateral venous flow through the bone, associated with a rise in intramedullary pressure, may be responsible for these findings.- - - - - - - - - - ranking = 1.4keywords = thrombophlebitis (Clic here for more details about this article) |
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