11/22. Focal giant papillary conjunctivitis from retained contact lenses.Three cases of retained contact lenses leading to focal papillary conjunctivitis of the upper lids reminiscent of the more diffuse changes of lens or suture-induced giant papillary conjunctivitis are reported. One silicone and two cabufocon lenses were responsible. Corneal changes occurred in two of the three cases. Secondary infection with staphylococcus aureus was found in one patient. In two, conjunctival cytology suggested a hypersensitivity mechanism. In all three patients the simple removal of the retained lens was sufficient to reverse pathology. The focal nature of the papillary changes observed in these patients as well as in those cases occurring post-operatively from exposed suture edges would point towards an important direct mechanical etiologic factor in addition to the proposed hypersensitivity basis for the similar diffuse upper lid papillary hypertrophy characteristic of giant papillary conjunctivitis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
12/22. The foot as a primary site for distant metastatic infection.Localized foot infection can lead to generalized sepsis under certain conditions. Two diabetic patients who suffered from infected foot ulcers, even after treatment with debridement and appropriate antibiotics, developed distant site infection. Another diabetic patient developed a distant site abscess from a chronic foot infection, for which he initially sought no medical treatment. Evaluation revealed that one patient had a psoas muscle abscess, one a renal abscess, and one an epidural abscess. All three patients were treated aggressively for their infections. One recovered fully, while two expired from septic complications associated with their illnesses. These case histories, along with the chronology of the development of sepsis from a foot infection are presented.- - - - - - - - - - ranking = 9keywords = infection (Clic here for more details about this article) |
13/22. Acute focal bacterial nephritis presented as acute renal failure and hepatic dysfunction in a renal transplant recipient.We describe acute focal bacterial nephritis (AFBN) presented as acute renal failure and hepatic dysfunction in a renal transplant recipient. He had received a renal transplantation 5 years previously and maintained good renal function without an episode of acute rejection or any urinary abnormalities. He had been an HBsAg carrier and showed mild elevation of liver enzymes after renal transplantation. For 5 days before admission, the patient suffered from fever, graft kidney swelling, tenderness and oliguria. On admission, renal biopsy was performed and solumedrol pulse therapy was started under the impression of acute rejection. The following laboratory findings revealed acute renal failure and hepatic dysfunction. From the abdomen CT and renal biopsy findings this case was confirmed as AFBN in a grafted kidney. With successive hemodialysis and antibiotic therapy clinical symptoms and renal function improved promptly. In acute hepatic dysfunction we discontinued cyclosporine (CsA) to prevent irreversible fulminant hepatic failure until the normalization of liver function. It should be considered that AFBN must be included in the differential diagnosis of acute rejection, and the early diagnosis and treatment of AFBN is important to save the grafted kidney. In addition, early withdrawal of CsA is essential to prevent irreversible hepatic failure when infection triggers hepatic dysfunction in HBsAg-positive renal transplant recipients.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
14/22. Acute lobar nephronia: a case report.Acute lobar nephronia (ALN), a term analogous to acute lobar pneumonia, refers to a renal mass caused by acute focal infection without liquefaction. An alternative term is acute focal bacterial nephritis (AFBN). fever, flank pain or back pain are the most frequently encountered clinical characteristics. Imaging modalities used to establish a definite diagnosis of acute lobar nephronia included sonography, computed tomography and nuclear medicine. Uroradiographic findings in this condition can mimic a renal abscess or neoplasm. Further distinction between acute lobar nephronia and other renal masses is aided by the appropriate use of renal sonography and computerized tomography is the most effective and least costly method in diagnosis. Serial sonograms can be used to monitor response to antibiotic therapy. Clinical and uroradiographic characteristics of a six year-old female patient with acute lobar nephronia are presented, along with a review of literature.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
15/22. Hepatic candidiasis: persistent pyrexia in a patient with acute myeloid leukaemia after recovery from consolidation therapy-induced neutropenia.fever, a frequent manifestation in acute leukaemia patients who develop treatment-induced neutropenia, usually resolves when the neutrophil count returns to normal irrespective of whether an infective agent is isolated or not. A persistent pyrexia following neutrophil recovery and associated with multiple negative microbiological cultures should signal a careful search for a deep-seated fungal infection in any leukaemic patient who is complete remission. We report here a 39-year-old Chinese man with acute myeloid leukaemia in first complete remission whose unresolved fever after recovery from consolidation therapy-induced neutropenia was ultimately confirmed to be caused by focal hepatic candidal microabscesses by an open liver biopsy.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
16/22. Polymicrobial polyfocal osteomyelitis and polymicrobial urinary tract infection in sickle cell disease--a case report.salmonella osteomyelitis is a well-known association of patients with sickle cell disease. This case report describes an infant with osteomyelitis having multiple foci and two pathogens including salmonella and staphylococcus aureus who was treated successfully. An additional unusual feature included urinary tract infection.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
17/22. Acute focal bacterial nephritis in childhood brucellosis.brucellosis is an infectious disease transmitted from various animal hosts to man. In children the most common route of infection is unpasteurized milk or milk products. brucellosis affects the urinary tract uncommonly, most frequently causing orchioepididymitis. We report the case of a 4-year-old boy with brucellosis who developed acute focal bacterial nephritis (AFBN), documented by sonography, gallium scan, and computed tomography. After appropriate treatment his symptoms and his sonographic abnormality resolved completely. To the best of our knowledge, this is the first report of the association of AFBN and brucellosis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
18/22. The clinical use of 99m-Tc-labeled WBC scintigraphy in critically ill surgical and trauma patients with occult sepsis.OBJECTIVE: To evaluate the clinical use of radionuclide-labeled white blood cell scintigraphy in the detection of focal sepsis. DESIGN: Prospective clinical study. SETTING: A medical/surgical 12-bed intensive care unit (ICU) in a university hospital. patients: 26 trauma and surgical patients affected by sepsis of unknown origin were studied. MEASUREMENTS AND RESULTS: After the usual diagnostic approach, patients were submitted to a total body scan by using the patient's leukocytes labeled with technetium-99m (99m-Tc) HMPAO; three scintigraphy were performed within 20 h of tracer injection; the result of scan was completed with all clinical and instrumental data, including ultrasound (US) arnd computed tomography (CT), and the diagnostic efficacy was demonstrated for each patient on discharge from the ICU. The scan was able to detect 20 sites of infection; it was possible to rule out 11 suspected sites; only in two cases was the result considered to be false positive or false negative; in two cases the result was considered to be uncertain. These results show the high sensitivity (95%), specificity (91%) and accuracy (94%) of the method. CONCLUSIONS: In ICU patients with sepsis, nuclear medicine can provide additional data, as the injection of radionuclide-labeled white blood cells (WBCs) allows the imaging of sites of infection. Analysis of our results suggests that scintigraphy with 99m-Tc-labeled WBCs can be considered a useful tool in the detection of the source of infection.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
19/22. Intracranial complications of sinusitis.Intracranial suppurative complications of sinusitis remain a challenging and contemporary topic. To determine the prevalence of sinogenic sources in intracranial infectious complications, we reviewed the records at a large public hospital between 1985 and 1995. There were 203 patients with 212 suppurative intracranial infections. Sinogenic sources were identified in 12 patients with 19 infections. Most patients had ethmoid or frontal sinusitis. We discuss the presentation, microbiology, diagnosis, treatment, and clinical course of these 12 cases. The diagnosis of intracranial complications of sinusitis requires a high index of suspicion and radiographic imaging of the head and paranasal sinuses. The mean hospital stay was 31.4 days and all 12 patients survived, although three patients had significant neurologic sequelae.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
20/22. Septic metastatic endophthalmitis from klebsiella pneumoniae liver abscess: CT and MR imaging characteristics--report of three cases.Computed tomography (CT) and magnetic resonance (MR) imaging were performed in three diabetic patients with endophthalmitis and liver abscess secondary to klebsiella pneumoniae infection. Ocular abnormalities included early uveoscleral thickening, fulminant exudative vitreous humor, and late phthisis bulbi. Characteristic imaging findings of endophthalmitis in diabetic patients with liver abscess should raise a high index of suspicion for K pneumoniae infection.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
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