1/5. Endogenous endophthalmitis and necrotising pneumonia caused by klebsiella pneumoniae in a child with beta-thalassaemia major.A case beta-thalassaemia major complicated with klebsiella pneumoniae endogenous endophthalmitis is presented to increase physician awareness of the association of the two clinical conditions. Severe morbidity including subretinal abscess and retinal detachment may develop despite aggressive intravenous and intravitreal ceftriaxone therapy, along with vitrectomy and external drainage.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Ruptured tubo-ovarian abscess as a complication of IVF treatment: clinical, ultrasonographic and histopathologic findings. A case report.Tuboovarian abscess is a rare complication of IVF treatment, which can be lethal on rupture. Hereby, we present a case of a ruptured tubo-ovarian abscess, following transvaginal ultrasound-guided oocyte retrieval for IVF and transcervical embryo trasfer in a 38-year-old white female patient with five years of primary infertility who underwent aspiration of bilateral hydrosalpinges at the time of oocyte retrieval. This case suggests that the reactivation of latent pelvic infection due to a previous pelvic inflammatory disease (PID) was the possible route of infection after transvaginal ultrasound-directed follicle aspiration--transcervical embryo transfer. We conclude that physicians should consider the diagnosis of tubo-ovarian abscess in the differential diagnosis of abdominal pain, fever and leukocytosis after ovum retrieval and transcervical embryo transfer for IVF treatment. Preservation of the uterus and unaffected uterine adnexa should be attempted in such cases if future pregnancy is desired.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. Endogenous endophthalmitis and disseminated intravascular coagulation complicating a klebsiella pneumoniae perirenal abscess in a patient with type 2 diabetes.We describe a 56-year-old woman with type 2 diabetes complicated by a Klebsiella pneumoniae perirenal abscess. The patient further developed incipient diabetic ketoacidosis, disseminated intravascular coagulation, and endogenous endophthalmitis. Occurrence of the latter as a metastatic infection from perirenal abscess caused by this organism is very rare, and we know of no previously reported patient with the additional occurrence of disseminated intravascular coagulation. Since prompt intravitreal antibiotic administration is needed, physicians should be aware of these rare but severe complications of K pneumoniae infection, especially in patients with poorly controlled diabetes.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. Hematogenous patellar osteomyelitis associated with human immunodeficiency virus.The case of a 37-year-old man with hematogenous osteomyelitis associated with the human immunodeficiency virus (hiv) is presented, with a review of the literature. Hematogenous osteomyelitis is a relatively rare entity in the patella; most cases have involved adolescents and immunocompromised patients. There have been no previous reports of hematogenous osteomyelitis in hiv-positive patients. The diagnosis requires clinical suspicion and roentgenographic evidence. Point tenderness over the patella and a painful, swollen knee joint are signs that should alert a physician to the possibility of hematogenous osteomyelitis. Laboratory studies are often of little value, and systemic symptoms are often absent. Treatment requires appropriately directed intravenous antibiotics and open drainage and curettage of the patella. Patellectomy may be required for large lesions and in instances of articular involvement. Computed tomography is a helpful diagnostic tool. The patient in this presentation had osteomyelitis of the patella with a knee pyarthrosis. He had open debridement of the extensor mechanism and knee joint, but ultimately required amputation because of repeat pyarthroses.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/5. Course and management of renal subcapsular abscess in a 63-year-old diabetic woman.Renal subcapsular abscess is a very rare disease that is defined by a suppurative process localized to a space between the renal capsule and the renal parenchyma. The course and management of subcapsular abscesses have received less attention than those of renal and perirenal abscesses. We describe a 63-year-old diabetic woman who presented with intermittent fever of 1 month's duration. She was initially treated for suspected acute pyelonephritis then referred to our hospital because of poor clinical response to cefazolin plus gentamicin. Computed tomography of the abdomen revealed a huge subcapsular abscess with displacement and compression of the left renal parenchyma. A percutaneous catheter was inserted and left in place for 8 days; a total of approximately 850 mL of pus was drained. culture of the pus yielded klebsiella pneumoniae and enterobacter cloacae. A 2-week course of moxalactam was administered on the basis of the results of in vitro antibiotic susceptibility testing. The distorted renal parenchyma appeared normal at sonographic follow-up examination 3 weeks after hospitalization. The course and management of this rare entity are presented as a reminder to physicians that renal subcapsular abscess could manifest as fever of unknown origin in a diabetic patient. A high degree of clinical suspicion is required for early diagnosis and treatment in order to achieve a satisfactory outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |