1/11. Zenker's diverticulum associated with multilevel cervical osteomyelitis.STUDY DESIGN: A case report of cervical osteomyelitis possibly associated with a Zenker's diverticulum perforation. OBJECTIVES: To present clinical, radiologic, and surgical findings of a cervical osteomyelitis due to a Zenker's diverticulum perforation. SUMMARY OF BACKGROUND DATA: A 56-year-old patient was in an intensive care unit for a severe head injury. He was fed via a nasogastric tube. Four months later he developed a pyogenic cervical vertebral infection. methods: Plain films and magnetic resonance imaging showed a diffuse cervical osteomyelitis. Investigation of his dysphagia revealed a Zenker's diverticulum. RESULTS: After administration of antibiotics and surgical treatment of the diverticulum, the cervical infection resolved. Plain films and magnetic resonance imaging showed healing with vertebral fusion. CONCLUSIONS: Cervical osteomyelitis is uncommon. Only one case of direct contamination leading to cervical vertebral osteomyelitis after esophageal perforation has been previously described. Direct contamination of the prevertebral soft tissues by bacteria traveling through the fistula may have occurred. The development of vertebral osteomyelitis in this case is consistent with the hypothesis of direct contamination. Management relies on appropriate antimicrobial therapy and surgical management of the diverticulum. The association of Zenker's diverticulum with vertebral osteomyelitis and discitis is a unique, previously undescribed situation.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/11. Primary pyogenic abscess of the psoas muscle.Nine children who were less than nine years old and had a primary pyogenic abscess of the psoas muscle were treated in a five-year period. This rare lesion often simulated septic arthritis of the hip. ultrasonography was found to be the most reliable and easily performed diagnostic study. Because of the rarity of the lesion, the diagnosis requires a high index of suspicion. The best treatment is early operative drainage and administration of systemic antibiotics.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/11. Effectiveness of intrapericardial administration of streptokinase in purulent pericarditis.BACKGROUND AND PURPOSE: Purulent pericarditis is very rare. However, among patients suffering from this disease the mortality rate is very high. The aim of this study was to evaluate the effectiveness and side effects of intrapericardial streptokinase administration in patients with confirmed purulent pericarditis. patients AND methods: Three patients, one 50-year-old man and two women aged 64 and 40 years, who were admitted to the intensive care unit (ICU) due to purulent pericarditis, entered the study. In all three cases a subxiphoid pericardiotomy followed by insertion of a drainage line into the pericardial space was performed. Antibiotic therapy was started immediately on admission to the hospital. Despite continued antibiotic therapy in all three patients, daily drainage from the pericardium--during several days after surgery--staggered between 50-200 ml/day. Due to considerable purulent pericardial drainage loculations and/or fibrin deposits confirmed by echocardiography, streptokinase (500,000 IU dissolved in 50 ml of normal saline) was administered into the pericardial space over 10 min, using the previously inserted drainage catheter. This regimen was repeated after 12 and 24 h. The total dose of streptokinase was 1,500,000 IU. RESULTS: The clinical effect of intrapericardial streptokinase administration was excellent. Several days after intrapericardial administration of streptokinase, drainage of purulent pericardial fluid stopped. No complications associated with intrapericardial streptokinase administration were observed. In the follow-up echocardiography (in two patients repeated 6 and 9 months after delivery of streptokinase), pericardial fluid and echocardiographic signs of pericardial constriction were not observed. CONCLUSION: Intrapericardial administration of streptokinase in purulent pericarditis is effective and safe.- - - - - - - - - - ranking = 9keywords = administration (Clic here for more details about this article) |
4/11. Pustular eruption following administration of cephradine.We report the case of an unusual generalized pustular drug eruption caused by the cephalosporin cephradine. Previously reported pustular drug reactions are briefly reviewed. We suggest that a reaction to an administered drug should be considered in the differential diagnosis when a patient presents with fever and a diffuse pustular eruption.- - - - - - - - - - ranking = 4keywords = administration (Clic here for more details about this article) |
5/11. Pyocephalus of the newborn child.3 cases of pyocephalus (ventricular empyema) in newborn children are described and 16 cases from the literature are analyzed. Half of the previously published cases of pyocephalus are secondary to cerebral abscesses. Neuroradiological findings and especially the necroscopic study of a case demonstrated the existence of membranous blockages inside the ventricles which may make the circulation of CSF impossible. Our treatment of choice consists of repeated punctures and evacuations of purulent content and topic as well as parenteral administration of antibiotics. Further CSF derivative measures are almost always necessary. By these means, we believe the high mortality of these cases could be lowered.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/11. Suppurative pylephlebitis due to pseudodiverticulosis coli.patients manifesting suppurative pylephlebitis and intrahepatic abscess formation secondary to pseudodiverticulosis coli and acute diverticulitis are uncommon, but have very high morbidity and mortality. As illustrated by this case report, the symptoms and signs such a patient manifests are nonspecific and the diagnostic modalities available may be insufficiently sensitive. The therapeutic options available at present are excision and drainage of any detected extrahepatic or intrahepatic septic focus and prolonged antibiotic administration.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
7/11. brucella suis: an unusual cause of suppurative lymphadenitis in an outpatient.A routine aerobic culture of purulent material from a draining sinus tract of a patient with chronic lymphadenitis yielded growth of a fastidious gram-negative coccobacillus later identified as brucella suis biotype 1. The patient responded to administration of antibacterial drugs and surgical drainage.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/11. Acute suppurative thyroiditis caused by salmonella enteritidis.Acute suppurative thyroiditis in a 47-year-old diabetic woman is reported. diagnosis was suspected by clinical examination and confirmed by ultrasound, CT-scan and cytological examination. A rare causative agent was isolated--salmonella enteritidis. No signs of nodular goiter or connection with piriform sinus were found. In spite of our efforts, the source and route of infection remained unclear. However, the haematogenic route seems to be the most plausible. Surgical drainage and antibiotics brought about a complete recovery. Partial lesion of the gland required transitory administration of levothyroxine.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
9/11. Postpartum pyometra: a case report.pyometra is an uncommon result of endometritis. The diagnosis of pyometra is made when a collection of pus is found within the endometrial cavity. Antibiotic administration and drainage of the pus are essential to resolve this condition. A report of a case of pyometra is presented and a technique for drainage is described. This case demonstrates the use of office-based diagnostic ultrasonography to narrow the differential diagnosis and guide the drainage procedure, as well as the use of simple ingenuity to improve patient care.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
10/11. Uterine pyomyoma as a complication of pregnancy in an intravenous drug user.Pyomyoma (suppurative leiomyoma) is a rare entity characterized by infarction and infection of a uterine leiomyoma. Pyomyomas may pose both diagnostic and therapeutic difficulties, leading to potential complications such as bacteremia, uterine rupture, and even death. In the case we describe, uterine pyomyoma occurred as a complication of pregnancy in a 31-year-old woman with a history of intravenous drug abuse. We postulate that the patient's illicit drug use caused transient bacteremia resulting in bacterial seeding of a uterine leiomyoma that had infarcted due to pregnancy. Therapy consisted of total abdominal hysterectomy and intravenous antibiotic administration. We believe this is the first reported case of a pyomyoma developing in association with intravenous drug abuse.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
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