1/23. Removal of infected pacemaker leads with deep hypothermic circulatory arrest and open surgical exploration of the superior vena cava and innominate veins.Despite the use of transvenous methods for extraction of infected leads, failed attempts may result in retained lead fragments. Retained lead fragments may be a focus of continued infection leading to sepsis. We present two patients in which conversion from cardiopulmonary bypass to hypothermic circulatory arrest allowed direct visualization, using venotomies in the superior vena cava and innominate vein to achieve complete removal of retained pacemaker lead fragments. Use of venotomies in the extracardiac venous system is a technical addition to prior descriptions of lead extraction using deep hypothermia and circulatory arrest.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/23. Brain abscesses from neglected open head injuries: experience with 17 cases over 20 years.We are reviewing our experience with 17 civilian cases with post-traumatic brain abscesses treated in the era of CT scanning over a period of 20 years. The principal cause for this intracranial complication was the neglected compound depressed fracture. One was a newborn infant with left parietal abscess caused by a vacuum extraction. We have used the following methods of treating the abscesses: single burr hole aspiration in the newborn with an excellent result; repeated aspiration, with debridement of the depressed fracture, in 5 cases (1 death); aspiration with early subsequent excision, via craniotomy, in 7 cases (no death), and primary excision, via craniotomy, in 4 cases (1 death). The early subsequent excision of the abscess, 2 or 3 days after the initial aspiration, has proved in our experience very satisfactory. In cases with bone fragment into the abscess cavity the excision of the abscess is indicated. The cultured pus from the abscess cavity showed mixed flora (streptococci and staphylococci) in 7 cases; staphylococcus aureus in 4; staphylococcus epidermidis in 2, and no growth in 4 cases. Antibiotics play an important role in the treatment of post-traumatic brain abscesses.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
3/23. brain abscess following delayed endoscopic removal of an initially asymptomatic esophageal coin.Brain abscesses are rare occurrences in pediatric patients, and making their diagnosis can be difficult. The two most commonly cited risk factors are otorhinologic infections and cyanotic congenital heart disease (CCHD). We present a 13-month-old child with a brain abscess who, 2 weeks prior, underwent rigid endoscopy for the extraction of a coin from the esophagus. We believe this to be the first such report of a brain abscess after rigid endoscopy for removal of an esophageal foreign body. In this case the esophageal coin was initially asymptomatic and had been present for weeks prior to removal. The potential association between delayed coin extraction and development of an intracranial infection, suggested by this report, may warrant investigation.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/23. Pott's puffy tumor and epidural abscess arising from dental sepsis: a case report.OBJECTIVE: To present an unusual case of two uncommon cranial complications of frontal sinusitis: Pott's puffy tumor and epidural abscess arising from frontal sinusitis of dental origin, and also two systemic complications of sinusitis: septicemia and empyema, all occurring in an immunocompetent patient. STUDY DESIGN: A 21-year-old man presented with a scalp swelling and epidural abscess. magnetic resonance imaging and computed tomographic scans revealed unilateral opacification of the frontal sinus and an epidural abscess with a direct connection to the scalp abscess. Further history revealed that his symptoms occurred coincidentally with a tooth extraction 2 months before, and he was hospitalized soon after the tooth extraction for sepsis and a lung abscess. methods: A combined neurosurgical and otolaryngologic approach was required to treat the sinusitis and the associated epidural and scalp abscess. RESULTS: Cultures returned as streptococcus intermedius from all three sites. The patient was free of disease at the 3-month follow-up. CONCLUSIONS: Odontogenic maxillary sinusitis is well documented; however, there is little reported of frontal sinusitis arising from dental disease. The prevalence of sinusitis of dental origin will be reviewed, including the microbiology of this particularly virulent organism that persisted despite earlier treatment with ampicillin. Also, the current thoughts on management of these cases will be discussed with particular reference to local therapy for sinusitis in addition to systemic treatment with antibiotics.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/23. Infected papillary fibroelastoma attached to the atrial septum.A 61-year-old woman had intermittent fever of 2 months' duration following a dental extraction. On admission, her body temperature was 39.2 degrees C. A mid-systolic murmur was heard at the apex on ausculation. A 2-dimensional echocardiogram revealed a mobile, heavy stick-like mass with vegetation (5.0 x 1.5 cm) attached to the left atrial septum. Multiple blood cultures grew streptococcus constellatus. On diagnosis of an infected left atrial myxoma, antibiotics were administered daily and 4 weeks later, the left atrial tumor was resected. The tumor was 5.3cm long, 1.5cm in diameter at the inter-atrial wall and had vegetation on the free edge. On microscopic examination, colonies of gram-positive cocci were found in the thrombus, on the papillary fibroelastoma. After treatment with antibiotics for a further 4 weeks, the patient was discharged. This is the first report of infected papillary fibroelastoma.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
6/23. A case of streptococcus pyogenes endophthalmitis following cataract surgery.A small number of cases of bacterial endophthalmitis due to streptococcus pyogenes, a Gram positive organism, have previously been reported. In this case, rapidly progressive streptococcus pyogenes endophthalmitis was developed five years after cataract surgery which had been. The previous cataract surgery was combined with intraocular lens implantation by trans-scleral suspension technique. Treatment included enucleation and intravenous antibiotic injection. In this case of delayed streptococcus pyogenes endophthalmitis after extracapsular cataract extraction. It seems probable that progressive erosion of the suture material resulted in exogenous endophthalmitis.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
7/23. Surgical extraction of infected pacemaker leads after cardiac surgery.Surgical extraction of permanent pacemaker leads is performed when noninvasive extraction is felt to be unsafe or has been unsuccessfully attempted. Surgical extraction in patients with previous cardiac surgery presents a particular challenge as re-sternotomy is hazardous and the presence of surgical adhesions makes video-assisted approaches difficult. We report 2 cases of successful deployment of a surgical technique using femorofemoral cardiopulmonary bypass and right anterior thoracotomy for removal of pacemaker leads.- - - - - - - - - - ranking = 3.5keywords = extraction (Clic here for more details about this article) |
8/23. mastoiditis in an immunocompetent adult.A 20-year-old white male presented to the family practice department with a 1-month history of right ear pain and loss of hearing. During the month, he had been seen in emergency rooms twice and also by his dentist. He had been treated with pain medications, tooth extraction, and finally, antibiotics. On presentation to the clinic, his right mastoid area showed erythema, tenderness, and swelling that displaced the pinna. He was immediately referred to the otolaryngology department. Imaging studies confirmed coalescent mastoiditis and subperiosteal abscess. He was taken to surgery, where he underwent cortical mastoidectomy and right pressure equalization tube placement. Intraoperative and postoperative intravenous cefotaxime was given. Recovery was complete and uneventful.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
9/23. Orbital abscess: visual loss following extraction of a tooth--case report.OBJECTIVE: It is the purpose of this article to alert the general practitioner to the severe consequences that may result from a tooth extraction, including the loss of vision, despite the use of antibiotics. CONCLUSIONS: Early and aggressive treatment is critical in obstructing the spread of infection toward the orbits, the eyes, and eventually the brain.- - - - - - - - - - ranking = 2.5keywords = extraction (Clic here for more details about this article) |
10/23. Septic arthritis of the temporomandibular joint successfully treated with arthroscopic lysis and lavage: case report and review of the literature.Septic arthritis of the temporomandibular joint (TMJ) is infrequently reported. We present a case of septic arthritis of the TMJ following the extraction of the left upper second molar that occurred 1 week before beginning of symptoms. No evident predisposing factors were detected. Arthroscopic diagnosis of septic arthritis, lysis and lavage, and capsular stretch were performed. Cultures taken from the TMJ space grew Streptococcus sp. After 1 month of antimicrobial therapy the patient was asymptomatic and mandibular function was normal. literature related to septic arthritis of TMJ and its treatment was reviewed. Different surgical procedures are available to treat this condition. arthroscopy should be preferred as initial treatment on account of the possibility of drainage and accurate lavage under direct visualization of joint space, at the same time allowing confirmation of diagnostic hypotheses. Improving joint mobility with lysis of adhesions and capsular stretch in an early stage of disease may be helpful in stopping the fibrosis process.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
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