1/13. Cerebral abscess after presumed superficial periorbital wound.Penetrating wounds in the periorbital region may appear superficial and minor at first glance. The unique shape and thin bony roof of the orbit give these injuries a significant risk of associated intracranial penetration. This can initially be asymptomatic, and a high index of suspicion is essential to properly diagnose and treat these injuries. We report a case of an 8-year-old female who presented with delayed seizures from a frontal abscess resulting from such an injury. This article reviews the literature and discusses the appropriate management that should be used by emergency room and military physicians.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/13. Spontaneously infected cephalohematoma: case report and review of the literature.Spontaneously infected cephalohematomas are rare occurrences; only five cases have been reported previously. Uninfected cephalohematomas are common and usually resolve without treatment. However, physicians should be aware that cephalohematomas are potential sites for infection and may require aspiration for diagnosis and treatment. Untreated infected cephalohematomas may lead to osteomyelitis, epidural abscess, or subdural empyema. We present a case of a spontaneously infected cephalohematoma with an associated osteomyelitis which was successfully managed with drainage and long-term antibiotics. A review of the literature is also presented.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/13. Rapidly growing tumor-like brain lesion.listeria monocytogenes accounts for 8-11% of the cases of bacterial meningitis which is associated with high mortality in patients with serious underlying diseases or those receiving immunosuppressive treatment. brain abscess due to L. monocytogenes is a very rare occurrence. The case reported here concerns a 54-year-old female patient with a rapidly growing tumor-like brain lesion. L. monocytogenes type 4b could be cultured from blood and brain biopsy. Despite antimicrobial therapy with ampicillin and gentamicin, the patient died 11 days after admission to the hospital. The growing numbers of elderly and immunocompromised patients will increasingly confront physicians with patients with listeriosis. Delayed therapy in patients treated with corticosteroids may result in a fatal outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/13. frontal sinusitis with chronic epidural abscess: a case presentation.The incidence of intracranial complications from acute frontal sinusitis has decreased with improved antimicrobial and surgical therapy. However, the physician must maintain a keen awareness and thoroughly investigate any possible signs of intracranial spread. This article discusses a case in which a chronic epidural abscess developed after inadequate therapy was rendered. It also reviews the presentation of and the factors leading to the development of intracranial complications. The treatment required is to eradicate the disease present and prevent future sinusitis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/13. Bacterial pituitary abscess: an unusual cause of panhypopituitarism.OBJECTIVE: To describe a case of primary bacterial pituitary abscess manifesting as hypopituitarism. methods: We present the case history, hormonal and bacteriologic data, and findings on imaging studies in a 34-year-old man. RESULTS: The patient had an 8-month history of intermittent fever, headache, nausea, vomiting, and weight loss. Because a computed tomographic scan of the head showed a cystic sellar mass with ring enhancement, he was referred to our medical center. On physical examination, he showed signs of meningeal irritation and had mild hypotension. Hormonal evaluation revealed evidence of hypocortisolism, hypothyroidism, and hypogonadism. Three weeks after treatment with antibiotics and hormonal replacement, he underwent transsphenoidal surgical exploration and evacuation of purulent material from the sella. On culture, this specimen grew coagulase-negative staphylococci and propionibacterium granulosum. Nine months later, dynamic testing showed persistent central hypocortisolism, hypothyroidism, and hypogonadism. CONCLUSION: Bacterial pituitary abscess is rare but manifests similar to other pituitary masses with headaches, visual field defects, and hormonal disturbances. For the correct preoperative diagnosis of this condition, the physician must have a high index of suspicion, and the characteristic ring enhancement must be present on imaging studies.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/13. A case of delayed brain abscess due to a retained intracranial wooden foreign body: a case report and review of the last 20 years.A 13-year-old female is presented. When she was six years old, she had fallen, holding wooden chopsticks and got stuck with a chopstick in the right upper eyelid. She was brought to a physician immediately, but a residual foreign body was missed and no particular symptom had developed during 7 years. She visited our department with fever and headache, and a brain abscess and an intracranial foreign body were found on computed tomography (CT) and magnetic resonance image (MRI) 7 years after the penetrating injury. She underwent removal of the object and abscess by craniotomy and recovered without neurological abnormalities. Since intracranial retained wooden foreign bodies frequently cause delayed complications of severe central nervous system infection, surgical removal is necessary even in the absence of symptoms.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/13. Prolonged unconsciousness in a patient with End-stage Renal disease.patients with End-stage Renal disease being immunocompromised; are prone to a variety of infections, sometimes, rare ones, more than the general population. This fact should alert the physicians to be more vigilant and have a broader scope when considering the etiology of infections in such patients. We report the case of a 65-year-old man who had a very stormy hospital stay secondary to cerebral nocardiosis with multiple brain abscesses, prolonged unconsciousness and neurological deficits. However, the patient was treated successfully, surgically and chemotherapeutically. He was discharged home in a good condition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/13. parietal lobe abscess after routine periodontal recall therapy. Report of a case.This paper reports on a case of a 70-year-old physician diagnosed with a parietal lobe abscess following such treatment. After stereotactic biopsy and drainage and a 6-week course of intravenous antibiotic treatment, the patient recovered with minimal neurologic deficits. Although brain abscesses are not commonly encountered in practice, clinicians must be aware of the potential virulence of the anaerobic components of the periodontal pocket and the possibility of resulting systemic infection, which can produce a life-threatening situation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/13. Intracranial complications of sinusitis.Sinusitis is a common problem that is routinely diagnosed and treated by most primary care physicians. Although most cases usually respond to appropriate therapy, some occasionally progress to the development of intracranial complications, including meningitis, osteomyelitis, epidural and subdural empyema, intracranial mucocele or polyps, and frank brain abscess. It is important to develop a rational approach to the diagnosis and treatment of these conditions. A high clinical index of suspicion must always be maintained, since symptoms are often masked by previous antibiotic therapy. Radiologic evaluation must always include computerized tomography (CT) for accurate diagnosis and surgical planning. Therapy includes surgical drainage and high doses of appropriate intravenous antibiotics. cefuroxime and metronidazole provide excellent broad spectrum antibacterial coverage. Only early recognition and appropriate therapy can reduce the potential morbidity and mortality associated with these life-threatening complications.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/13. epidural abscess and subdural empyema.epidural abscess and subdural empyema are serious intracranial infections that result in significant morbidity and mortality. Frequently, they are secondary to sinusitis or middle ear disease, and the bacteria involved are inhabitants of the upper respiratory tract. Symptoms may be mild and mimic the symptoms of the underlying infection. However, especially with subdural empyema, alteration in the level of consciousness and focal neurologic deficits are common. morbidity and mortality are minimized by early diagnosis, which is best made with computed tomography scanning, and proper therapy, which consists of surgical drainage and administration of appropriate antimicrobials. It is important that primary care physicians be aware of the clinical features of these potentially fatal complications of common infections.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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